Which headlight to buy?

[mdwolf]

Hello,

I am first year resident of ENT but not in USA (apologize for my unintentional language mistakes).

I was searching for an advice on buying headlight but not for the purpose of OR than for regular examinations in infirmary. I am a little bit tired of catching a light with my head mirror But also, I guess my patients would appreciate the possibility where I do not have to light them with reflector to see something whether it is in nose or ear cavity.

At first I have seen the on from Welch Allyn like this one:
http://www.welchallyn.com/products/en-us/x-11-ac-100-0000000001085.htm
or this one:
http://www.reddylite.com/pages/reddylite1-2.htm.

From experience, is it better to buy one headlight with LED or xenon, or even halogenic light?
Does the temperature of light (LED, xenon, halogen) distort the colour of what we look at?
I have made a research over the forum but not found what I was looking for.

Tnx for all insight....

---

Members don't see this ad.

 

[resxn]

I have this one and like it a lot. No significant color distortion, doesn't get too hot--only have had it on for about 45 mins at the longest, though. Comfortable. Bright light. Battery lasts a long time--I have two and charge one while wearing the other. One battery lasts a full week without needing to charge. http://www.welchallyn.com/products/en-us/x-11-ac-100-0000000001087.htm

 

[lighttech]

I think we make the best value in headlights. But I may be biased.
http://www.light-tech.com/Merchant2/merchant.mvc?Screen=CTGY&Category_Code=700

We also do a special build on request with a reflecting mirror with a peep hole specifically for ENT. But you would need to call the factory to get that one.

I think our customer service can't be beat as well.

 

[kwolicki]

as a practicing Otolaryngologist x 30 yrs, I think I can speak with some authority.

Make no mistake, the concentric view through the head mirror allows naked eye visualization down very small holes (i.e. the nose, ear) and when accessible by mirror examination, the view is superior to even a flexible laryngoscope. The downside is the need to have a non-moving subject and the correct geometry with a light source and your mirror. For children, or maybe hospital consultations, a single light source headlight, as those pictured above, will be adequate for many purposes. In my office, we're about half and half headlights vs head mirrors. I can tell you, though, that I see things deep in the nose with my head mirror exam that my partners cannot see with a headlight and must resort to an endoscope (there is always a parallax error between your line of sight and the position of the light source, no matter how tightly collimated.)

The one exception is the Lempert headlight which I find indispensible in the operating room, doing minor nasal procedures in my office, and as a mobile light source when in the hospital. Again, the slotted mirror with the light bulb directly between the eyes reduces parallax error well. The design is old, but never yet surpassed. I understand they are going out of production (Karl Storz) but no one has yet shown me an acceptable replacement that is as functional. The Lempert would be rather ungainly going from room to room seeing patients, and to my knowledge, there is no battery powered version available. People have proposed the Welch Allen which has adjustable interocular distance, magnification, and a central light source (it is basically like two small periscopes, one for each eye, to bring the optical axes closer together) The concept is good, but I find actually using one, especially with bi-focal glasses, just about impossible.

Good luck- whatever you choose you'll be using a lot, and depending on it for the accuracy of your examinations.

 

[resxn]

and when accessible by mirror examination, the view is superior to even a flexible laryngoscope.

I don't disagree with anything in your post but this single phrase. I don't think that this could even be close to an acceptable argument in the face of distal chip scopes and HD video. Back when you and I started and the scopes were similar to looking through the Chunnel, this statement would be completely accurate.

And with modern laryngology, head mirrors cannot come close to giving us the resolution of a distal chip or 70degree scope strobe exam and are useless for trying to obtain the data you can get with videokymography (although most general ENT's couldn't care less about this to be honest). The last advantage to scopes over standard head mirror (or headlight for that matter) which has just been gaining traction in the literature in the last 2 years or so is narrow band lighting which improves the detection of dysplasia, CIS, and very small T1 tumors on mucosa surfaces--particularly the hypopharynx/base of tongue.

Now, from a non-diagnostic standpoint, let's consider a medicolegal issue. Scopes allow photographs--head mirrors do not. This is an increasingly important documentation issue. It's much easier to prove to a jury that the patient's exam was thorough and negative with photodocumentation than it is to just say it out loud.

Finally, there is a tremendous reimbursement benefit for a well-documented endoscopic exam vs using a plain light source of any kind.

My overall take on this argument is that while there are certainly advantages to the head mirror over the headlight, the growing technological advancements available for scopes are starting to outweigh the benefits of the head mirror or headlight and that because of this, these lightsources will be used to facilitate procedures rather than being used as diagnostic tools in the not too distant future. I won't be at all surprised when a study shows up using a scope to document an intraoral exam and is shown to be more accurate in detecting concerning lesions than traditional techniques. It may being written up as we speak. . .

 

[mdwolf]

Hello,
after a year or a liitle bit longer

My hospital bought KLS Martin headlight and after half of year of using them lot of people say - it`s not what we were hoping for
The light is too "blue" - when I see something with natural light and head-mirror it is far more superior and the picture is much more natural. Everything is "too-blue"
Factory sheets say that KLS headlight operates on 5000 K temperature.

Secondly, with head-mirror I can close to my patient much more than with the headlight. With headlight I have to be at least one meter (40 inch) away to even see anything in nose, for example. With my head-mirror I can see details on half of the aformentioned distance.
I have to say that I am little bit confused - where is that headlight superiority?

 

[resxn]

Hello,
after a year or a liitle bit longer

My hospital bought KLS Martin headlight and after half of year of using them lot of people say - it`s not what we were hoping for
The light is too "blue" - when I see something with natural light and head-mirror it is far more superior and the picture is much more natural. Everything is "too-blue"
Factory sheets say that KLS headlight operates on 5000 K temperature.

Secondly, with head-mirror I can close to my patient much more than with the headlight. With headlight I have to be at least one meter (40 inch) away to even see anything in nose, for example. With my head-mirror I can see details on half of the aformentioned distance.
I have to say that I am little bit confused - where is that headlight superiority?

First, I didn't say headlights were superior to mirrors--there are great arguments for each side. Distal chip HD scopes are unequivocally better and I'll argue that to my grave.

Second, since you brought it up, there are headlights that are much warmer than 5000K. Of course the mirror has a warmer light because it's usually a halogen bulb (6500+K), not xenon (4500-5500k) or LED (4000-5000K). You're not using a "natural light" with your headlight. Natural light is 5000K, you're using warmer light than "natural light." You can get the same blue light with a bad light source for the head mirror (i.e. if you used a mirror with an LED light source, you'll still get a blue feel to the tissue). Sounds like your hospital got screwed by a bad light source. That's not the fault of the headlight itself.

Last, there are headlights (usually LED or Halogen, but some expensive Xenons too) which have very low profiles and allow you to get close to the patient. Mine allows me within a foot of the mouth or nose; and to be honest, I don't want to be closer or they'll think I'm trying to get fresh with them. If your headlight doesn't let you get closer than a meter, you're not using anything built since 1990. That's just ridiculous. How could you even operate if you had to be over 3 feet away?

 

[mdwolf]

First, I didn't say headlights were superior to mirrors--there are great arguments for each side. Distal chip HD scopes are unequivocally better and I'll argue that to my grave.

Second, since you brought it up, there are headlights that are much warmer than 5000K. Of course the mirror has a warmer light because it's usually a halogen bulb (6500+K), not xenon (4500-5500k) or LED (4000-5000K). You're not using a "natural light" with your headlight. Natural light is 5000K, you're using warmer light than "natural light." You can get the same blue light with a bad light source for the head mirror (i.e. if you used a mirror with an LED light source, you'll still get a blue feel to the tissue). Sounds like your hospital got screwed by a bad light source. That's not the fault of the headlight itself.

Last, there are headlights (usually LED or Halogen, but some expensive Xenons too) which have very low profiles and allow you to get close to the patient. Mine allows me within a foot of the mouth or nose; and to be honest, I don't want to be closer or they'll think I'm trying to get fresh with them. If your headlight doesn't let you get closer than a meter, you're not using anything built since 1990. That's just ridiculous. How could you even operate if you had to be over 3 feet away?

I am apologizing myself if you have understood as I am writing a critique on your post.
Everything what I have written is just my observation after my hospital bought new headlights.

This is what we have:
http://www.klsmartin.com/MedLED-Focus-Headlig.26034+B6Jkw9Mg__.0.html
And it is obviously newer than 1990.

With a head mirror we are not using halogen bulb, we are still using this kind of bulb:
http://short-url.co.uk/?1=4C
So I am not sure what do you consider as - natural light?

Well, I am not using it for operating than for a patient examinations.
Actually, if I have to remove stiches - I will use a headlight inspite of the light temperature.

I do not want to jump into their mouth but to have opportunity to watch the patients from a foot distance is perfectly acceptable.

 

[drhobie7]

If you want a super cheap ($50) option search amazon for the LED lenser h7. I got one a while back and it's good. Super bright. Focuses down. Small.

 

[lighttech]

as a practicing Otolaryngologist x 30 yrs, I think I can speak with some authority.

Make no mistake, the concentric view through the head mirror allows naked eye visualization down very small holes (i.e. the nose, ear) and when accessible by mirror examination, the view is superior to even a flexible laryngoscope. The downside is the need to have a non-moving subject and the correct geometry with a light source and your mirror. For children, or maybe hospital consultations, a single light source headlight, as those pictured above, will be adequate for many purposes. In my office, we're about half and half headlights vs head mirrors. I can tell you, though, that I see things deep in the nose with my head mirror exam that my partners cannot see with a headlight and must resort to an endoscope (there is always a parallax error between your line of sight and the position of the light source, no matter how tightly collimated.)

The one exception is the Lempert headlight which I find indispensible in the operating room, doing minor nasal procedures in my office, and as a mobile light source when in the hospital. Again, the slotted mirror with the light bulb directly between the eyes reduces parallax error well. The design is old, but never yet surpassed. I understand they are going out of production (Karl Storz) but no one has yet shown me an acceptable replacement that is as functional. The Lempert would be rather ungainly going from room to room seeing patients, and to my knowledge, there is no battery powered version available. People have proposed the Welch Allen which has adjustable interocular distance, magnification, and a central light source (it is basically like two small periscopes, one for each eye, to bring the optical axes closer together) The concept is good, but I find actually using one, especially with bi-focal glasses, just about impossible.

Good luck- whatever you choose you'll be using a lot, and depending on it for the accuracy of your examinations.

The headlight you described sounds very much like the ENT reflecting light we make. This is available with our LED lights as well. Our LEDs are as pure white as we can get. No blue. Not even a hint of blue.