The importance of a Murphy Eye

Airway management in patient with continuous bleeding lesion of the trachea: a case report

“…Another method we considered before establishing this ventilation strategy was to maintain lung ventilation by cutting the distal part of the cuff in the endotracheal tube. As there is only one end hole, the disadvantage of this method is that the ventilation may be completely obstructed if the tip of the endotracheal tube touches the tracheal wall or is clogged by a tracheal excretion, bleeding, or lump [ 9 10 ]. However, the method presents an advantage in that it may prevent improper ventilation through the Murphy eye occurring during the operation from a change in the direction or depth of the Murphy eye and placement of the endotracheal tube in the farther distal part with a distance large enough to cut the cuff and the Murphy eye.…”

Evaluation of intubating conditions using stylet by conventional through-tube technique and through Murphy′s eye in patients with high Mallampati scores

“…The Murphy's eye first reported by Murphy in 1941, it is a side vent for ventilation in case the tip of the tube get hugged to the walls of the trachea and get blocked. [ 5 ] The use of Murphy's eye has earlier been described in a case of retrograde intubation by threading the guide wire through the Murphy's eye and thus intubation was successfully done. [ 6 7 ] Though the use of Murphy's eye with the bougie has been described in a case of difficult intubation but the use of stylet through Murphy's eye in difficult airway and its efficacy in cases of difficult intubation has not been tested in literature till date.…”

A response to ‘Post intubation airway obstruction in thyroid surgery’, Bourdeaux C, Benton J, Anaesthesia 2003; 58: 187–8.

“…Armoured tubes are recommended in patients with marked tracheal compression or deviation, as they are less likely to kink during surgical manipulation [1]. A similar case of life‐threatening obstruction, secondary to tracheal deviation by a retro‐pharyngeal haematoma, emphasised the importance of the Murphy eye [2]. Perhaps Dr Tamakawa was correct when he suggested that every tracheal tube needs a Murphy eye [3].…”