Combined rigid videolaryngoscopy-flexible bronchoscopy for intubation

To the Editor

We read with interest the article by Choi et al. [1] in which the authors report a case of a airway management with combined use of glidescope® videolaryngoscope and fiberoptic bronchoscope in a patient with a supraglottic mass. This case report addresses the important clinical concept of the combined use of flexible bronchoscopy with rigid videolaryngoscopy to benefit from the strengths of both techniques. The videolaryngoscope allows vision of the position of the tip of the bronchoscope and facilitates progression of the bronchoscope towards the larynx by keeping the oropharynx open and reducing erratic lateral advancement.

We would like to congratulate Choi et al. for adding to the largest previously published case series describing this multimodal airway approach. Sixteen patients without predicted abnormal airway were successfully intubated on the first attempt with the combined use of a videolaryngoscope (DCI, Karl Storz, Tuttlingen, Germany) and of a flexible bronchoscope [2]. The association of a videolaryngoscope and a flexible bronchoscope has to be considered as a concept that is independent of the specific brand or type of videolaryngoscope and flexible bronchoscope. Choi et al. confirmed the potential utility of this technique for the management of both normal and difficult airways.