Abstract
The technical paper focuses on establishing a method to stabilize a laryngoscope during a specific kind of exercise testing. Exercise induced laryngeal obstruction (EILO) is a condition in which the airway narrows at the larynx during exercise, leading to symptoms such as shortness of breath, wheezing, throat tightness, and anxiety. It is often misdiagnosed as asthma due to overlapping symptoms, making accurate diagnosis critical. The current gold standard for diagnosis is continuous laryngoscopy during exercise (CLE) testing, in which a flexible laryngoscope is inserted through the nose to visualize the airway while the patient exercises. A major limitation of this procedure is the difficulty in securely attaching the laryngoscope to the patient during movement. Existing methods are often unstable, improvised, and not designed for consistent sterilization. This project developed a head-mounted stabilization system to improve the reliability of continuous laryngoscopy during exercise testing. The final design consists of a modified welding headpiece combined with custom three-dimensional printed bands and mounting components. These printed components attach to the headgear and securely hold the laryngoscope in place. A protective interface using single-use tape was incorporated to prevent surface damage to the instrument while maintaining stability. The design process involved multiple iterations in CAD, informed by feedback from preliminary testing and clinical observation. Early prototypes identified issues with stability and adjustability, leading to the addition of a secondary attachment point and redesign of the tightening mechanism to improve fit and ease of use. A fully assembled prototype was fabricated and evaluated through simulated use conditions. Stability was assessed by measuring displacement during subject movement, and structural integrity was analyzed using stress simulations. Results demonstrate improved stabilization of the laryngoscope during movement, with reduced displacement compared to existing setups. The device also allows for consistent positioning and can be effectively sanitized between uses. This system provides a more reliable and user-friendly approach to continuous laryngoscopy during exercise testing, improving the diagnostic process for exercise induced laryngeal obstruction. The STS paper examines how environmental stressors and limited access to otolaryngology specialists interact to produce disparities in upper airway healthcare in rural Virginia. In many rural communities, patients face significant barriers when seeking specialized care, including long travel distances, limited provider availability, and delayed appointments. At the same time, these regions often experience higher exposure to environmental and occupational risk factors such as particulate matter from coal mining and dust from agricultural labor, which can increase the prevalence of respiratory and upper airway conditions. This study uses a literature review and a case study of Wise County, Virginia to explore how these factors overlap. Existing research demonstrates that air pollution, particularly fine particulate matter, is associated with increased risk of respiratory disease and head and neck cancers. Occupational exposures in mining and agricultural settings further contribute to chronic irritation of the upper airway. Despite this increased need for care, rural regions have significantly fewer otolaryngologists, which limits access to specialized diagnosis and treatment. Using Actor Network Theory as a framework, this paper analyzes how both human actors, such as patients and healthcare providers, and non human actors, such as environmental exposures, geographic barriers, and medical technologies, interact within the healthcare system. The case study illustrates how residents in Wise County experience both higher demand for ENT services and greater barriers to accessing those services. The findings suggest that disparities in rural healthcare are not caused by a single factor, but rather by the interaction of environmental conditions and structural limitations within the healthcare system. Addressing these disparities requires a broader approach that considers both environmental health risks and access to specialized care. Working on both the technical project and the STS paper provided a more complete understanding of the challenges in otolaryngology care. The technical project focuses on improving continuous laryngoscopy during exercise testing by creating a more stable and effective device. This work highlights the importance of accurate diagnosis and the role that medical technology plays in improving patient outcomes. At the same time, the STS research shows that access to these technologies is not equal across different populations. While advanced diagnostic tools may improve care in well-resourced clinical settings, rural communities often lack access to both the specialists and the equipment needed to use them. This demonstrates that technological innovation alone is not enough to address healthcare disparities. Instead, improvements in access, infrastructure, and distribution of care are also necessary. Together, these projects show how both technological and social factors must be considered to improve healthcare outcomes.
