Abstract
The physical restrictions imposed by the walls of the laryngoscope tube reduce visibility and freedom of access to many laryngeal lesions. The diameter of the mouth, unlike that of other body orifices, is large enough to permit solutions to this problem. Some such were developed years ago with only a modicum of success, which probably explains their virtual disappearance from the surgical scene. Prior to 1916, Bruening, Mosher, and Ingals1 all developed laryngoscopes with one side open to give more room for instrumentation. These were hand-supported, thus leaving one hand of the operator for surgical purposes. In addition, the surgeon's unbalanced crouch imposed a handicap. The suspension apparatus was pioneered by Killian and others, and finally securely established by Lynch.2 This created an open field which made extensive peroral surgery a practical reality. As Lynch's followers have proved,3 the use of this apparatus permitted accurate two-instrument dis