Fiberoptic bronchoscope and C-MAC video laryngoscope assisted nasal-oral tube exchange: two case reports

Abstract

In cases of multiple facial trauma and other specific cases, the anesthesiologist may be asked to convert an oral endotracheal tube to a nasal endotracheal tube or vice versa. Conventionally, the patient is simply extubated and the endotracheal tube is re-inserted along either the oral or nasal route. However, the task of airway management can become difficult due to surgical trauma or worsening of the airway condition. Fiberoptic bronchoscopy was considered a novel method of airway conversion but this method is not useful when there are secretions and bleeding in the airway, or if the anesthesiologist is inexperienced in using this device. We report a successful airway conversion under the aid of both, a fiberoptic bronchoscope and a C-MAC video laryngoscope.

Orotracheal intubation in a patient with difficult airway by using fiberoptic nasotracheal intubation: A case report

“…If mask ventilation is possible, other airway management devices may be considered [ 12 ]. Recently, clinical application of video laryngoscopy has been very helpful in resolving difficult intubation cases [ 1 ]. Moreover, the method of intubation after the insertion of a supraglottic device, such as a laryngeal mask airway, is also applied [ 4 ].…”

“…There are cases in which switching to nasal intubation becomes necessary for intraoral approach during an operation with oral intubation [ 1 ], or in which nasal to oral endotracheal tube exchange is necessary for nasal or facial surgery [ 14 ]. The method of switching from a nasotracheal tube to an orotracheal tube without extubation has been introduced [ 15 ], and there are reported cases of its use as well [ 14 ].…”

“…When oral intubation with a direct laryngoscope fails, other airway management devices may be considered if mask ventilation is possible. Video laryngoscope [ 1 ], light wand [ 2 ], fiberoptic scope [ 3 ], or a supraglottic device [ 4 ] may be used; however, the most appropriate choice may be to use the method that the anesthesiologist is most familiar with and in which there is the greatest confidence in a successful outcome. Depending on the situation, a nasal intubation may be attempted, rather than an oral intubation, if the former is believed to be more favorable than the latter.…”

Diagnostic Value of Multi-Slice Spiral Computed Tomography for Bronchial Dysplasia in Premature Infants

“…Most patients were diagnosed with bronchial hypoplasia combined with pulmonary infection [ 31 ], and MSCT and FB examination cannot determine whether there is inflammatory stenosis or congenital dysplasia. In the meantime, pulmonary infection may cause edema and mucus embolism in the lung tissue which interfere with the results of MSCT, making it impossible judge whether there is local stenosis.…”

Video-Twin Technique for Airway Management, Combining Video-Intubating Stylet with Videolaryngoscope: A Case Series Report and Review of the Literature

“…The idea of using laryngoscopy to facilitate other airway management tools (e.g., to achieve a better glottis visualization) is not new. In numerous reports, either DL or VL has been used to assist fiberoptic bronchoscopy (FOB) in various clinical scenarios [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. DL was also reported in combination with the fiberoptic stylet to assist in clinical and simulated difficult airway cases [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ].…”