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Lift and Tilt Laryngoscopy Trainer

Sean Graves, Emily Lickert, Harold Cook, Kaitlin Chung, Nickolai Miller, Sejeal Katiyar, Brandon Barber, Daniel Yates, Dr. James Snyder M.D.

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This project centers on developing an airway simulator to instruct medical professionals on how to properly conduct a direct laryngoscopy.

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During the project's duration, I have utilized the following skills:

  • 3D printing

  • Molding and casting

  • High resolution sketching

  • Rapid prototyping

  • Project Management

  • Anatomy and Physiology

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Overview

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Current laryngoscopy simulators lack realism in both their materials and the actual construction of the mannequins. They fail to provide the actual mechanical dynamics by which the airway is related to other structures, such as the hyoid bone, epiglottis, and trachea. Current trainers do not simulate the epiglottic "flip up", which refers to the movement of the epiglottis upon pressure placed upon the hyoepiglottic ligament by a laryngoscope's blade. Flipping up the epiglottis allows a full clear view of the glottis and the vocal cords. Current trainers do not focus on ligaments pertinent to this procedure such as the hyoepiglottic ligament and the stylohyoid ligaments, which all play roles in the procedure. It is important that this trainer simulates the epiglottic "flip up", any spinal movements that occur through head positioning, and includes the appropriate anatomy that current trainers do not include. 

Ideation

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Important features of the trainer we determined through ideation included:

  • Epiglottic "flip up"

  • Thoracic spinal movement in addition to cervical spinal movement

  • Definable anatomical parts like the hyoid bone, epiglottis, trachea, and larynx

  • Able to position the head in a "lift and tilt" fashion in order to get a clear view of the glottis

Prototyping

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A major focus of the project concerned the upper airway (hyoid bone, larynx, and trachea). Using 3D printing, CAD modeling, and low resolution prototyping, several prototypes were made in order to:

  1. Simulate anatomical movement, specifically the hyoid bone being able to slide forward and the larynx and trachea to have a hinge-like movement.

  2. Simulate the epiglottic "flip up", where a laryngoscope's blade can press on the hyoepiglottic ligament and cause the epiglottis to move forward and expose the glottis

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Another major focus of the project concerned the spine and its movement. Using 3D printing, CAD modeling, and low resolution prototyping, several prototypes were made in order to:

  1. Extend the spine beyond the cervical region and include model vertebrae down to T6.

  2. Simulate spinal movement in accordance to the "lift and tilt" method of intubation

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Feedback was given by Dr. James Snyder M.D., the sponsor of this project.

Final Iteration

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The final iteration had achieved many of our goals. The trainer included:

  • Anatomically accurate hyoid bone movement

  • Active epiglottal movement

  • Articulated spine with anatomical limits

  • Independent airway able to move relative to the spinal column 

  • Inclusion of additional ligaments

  • Hyoepiglottic and Stylohyoid ligaments

  • Visible vocal cords

©2021 by Sean Graves

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