Reducing injury during video-assisted endotracheal intubation: The “Smart Stylet” concept§

Authors

  • Philip A. Weissbrod MD,

    Corresponding author
    1. Division of Laryngology, Department of Otolaryngology—Head and Neck Surgery, The University of Washington School of Medicine, Seattle, Washington, U.S.A
    • Department of Otolaryngology—HNS, University of Washington School of Medicine, Box 356515, 1959 NE Pacific Street, Seattle, WA 98195
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  • Albert L. Merati MD

    1. Division of Laryngology, Department of Otolaryngology—Head and Neck Surgery, The University of Washington School of Medicine, Seattle, Washington, U.S.A
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  • Presented at the American Laryngological Association Annual Meeting, Chicago, IL, April 27, 2011.

  • The authors have no financial disclosures for this article.

  • §

    The authors have no conflicts of interest to disclose.

Abstract

Objectives:

Video-assisted endoscopic intubation (VAEI) has gained wide use in anesthesiology when difficult intubation is encountered. Even when excellent visualization of the larynx is achieved with VAEI, successful intubation can be difficult and/or traumatic due to awkward angles and rigid stylets. Presented is a modification of standard VAEI procedure that allows for minimization of intubation trauma.

Methods:

Technical description of VAEI with “smart stylet” for laryngeal surgical patients.

Results:

For difficult intubations, a GlideScope™, a type of VAEI, is used in combination with a flexible bronchoscope acting as a “smart” stylet. The bronchoscope is not used for its light or fiberoptic capacity, but rather as a manipulatable stylet for the endotracheal tube. The technical description of this technique is presented with illustrative images and online video content.

Conclusions:

The “smart stylet” concept allows for successful and safe endotracheal intubation when used with the Glidescope™.

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