A modified bite block for fibreoptic bronchoscopy in patients with face and neck scars.

摘要

To the Editor,Awake fibreoptic intubation is often considered to be the "gold standard" method of difficult airway management. However, a common concern when using the oral route is damage to the fibreoptic bronchoscope (FOB) due to biting. Also, passing the FOB in the midline is pivotal for successful fibroscopy. Although special intubating airway devices are designed to solve these issues, they are difficult to insert in awake patients with a severely limited mouth opening. In burn patients, head and neck movements are also limited by scar contractures, and these airway devices can occasionally make fibroscopy difficult because their distal opening may move from the glottis or even face the posterior pharyngeal wall.During the past seven years, we have attempted to use a modified bite block as a substitute for the special intubating airways during awake fibreoptic orotracheal intubation in patients with an airway made difficult because of face and neck scar tissue.