Virtual endoscopy—a new assessment tool in difficult airway management

Ahmad, Imtiaz; Millhoff, Britta; John, Martin; Andi, Kavin; Oakley, Richard

doi:10.1016/j.jclinane.2015.03.022

Cited by 31 publications

(23 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Virtual endoscopy facilitates an anatomically accurate reproduction of endoscopic findings within the airway in a format that is easily interpreted by the anesthesiologist. 18 Virtual visualization of the airway using preexisting CT images aids in planning an airway strategy. The added advantage of this technology is that any anesthesiologist who undertakes a short period of self-training can reconstruct a VE of the patient's airway as part of a comprehensive airway assessment.…”

Section: Discussionmentioning

confidence: 99%

“…The added advantage of this technology is that any anesthesiologist who undertakes a short period of self-training can reconstruct a VE of the patient's airway as part of a comprehensive airway assessment. 18 Previous studies and case reports have shown the use of VE to aid in the airway assessment of patients with head and neck pathology, 19,20 but this novel study evaluates the influence of VE videos not only on diagnostic accuracy but also on airway management planning.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of virtual endoscopy on diagnostic accuracy and airway management strategies in patients with head and neck pathology: a prospective cohort study

El‐Boghdadly

Onwochei

Millhoff

et al. 2017

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The effect of virtual endoscopy on diagnostic accuracy and airway management strategies in patients with head and neck pathology: a prospective cohort study

El‐Boghdadly

Onwochei

Millhoff

et al. 2017

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…Computer software now exists allowing these images to be translated into a virtual endoscopic video, providing the anaesthetist with a more familiar visualization of airway abnormalities. 5 Flexible nasendoscopy, however, remains the gold standard dynamic assessment of the preoperative airway. It should be noted that nasendoscopic images taken in surgical clinics will typically be filed in a patient's notes orientated with the posterior glottis superiorly.…”

Section: Assessment and Investigationmentioning

confidence: 99%

Anaesthesia for laryngo-tracheal surgery, including tubeless field techniques

Pearson

McGuire

2017

BJA Education

View full text Add to dashboard Cite

Laryngo-tracheal surgery presents the anaesthetist with numerous challenges including a shared airway with potential for airway compromise pre-, intra-or postoperatively. Surgical desire for a tubeless field in patients with acute or chronic laryngeal or tracheal pathology can be a daunting prospect for anaesthetists unfamiliar with these techniques. With careful preoperative planning and multidisciplinary communication, the most appropriate strategy for oxygenation and anaesthesia can be agreed. Although frequently the domain of the 'head and neck' specialist, all grades of anaesthetist may be faced with these challenging cases, particularly urgent scenarios, out of hours and in non-tertiary centres. Furthermore, proficiency in techniques such as airway topicalization, high-flow nasal oxygenation, and jet ventilation are beneficial in other areas of clinical practice. Lessons learned NAP4 The 2011 4th National Audit Project (NAP4) of the Royal College of Anaesthetists and the Difficult Airway Society investigated major complications of airway management in the United Kingdom. More than one-third of cases detailed in NAP4 involved an airway problem in association with an acute or chronic disease process in the head, neck, or trachea. 1 Approximately 70% of these patients presented with airway obstruction, with the majority requiring either anaesthesia for diagnostic and resective surgery or intervention to maintain airway patency. Expert reviewers considered airway management to have been poor in many of these reported cases, with inadequate patient assessment, planning, and team communication repeatedly cited failings. Recurring themes included airway deterioration following inhalational induction and repeated failure in direct laryngoscopy attempts. Major complications of high-pressure source ventilation A 2008 national survey exploring major complications during anaesthesia for elective laryngeal surgery in the United Kingdom found that this type of surgery was being performed in 62% of responding hospitals. 2 Across these sites, 67% were using high-pressure source ventilation (HPSV) with supraglottic, subglottic, and transtracheal routes being chosen by 86, 50, and Key points • Providing anaesthesia for surgery to the larynx and trachea is associated with a higher risk of airway complications and a need for skills in a variety of specialist techniques.

show abstract

“…Recently, however, there has been an increase in the use of accurate pre-operative assessment tools such as nasendoscopy, virtual endoscopy and ultrasound [21][22][23], which contribute to better imaging and assessment of the difficult airway. These techniques help in pre-operative assessment and provide an improved overall picture of the airway, reducing the unknown elements and hence allow for more familiar techniques to be used safely.…”

Section: Improved Imaging Techniquesmentioning

confidence: 99%