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Updated: Oct 8, 2026

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation
Published on: August 2, 2024
Non-inflatable sterile sheath for introduction of the flexible nasopharyngolaryngoscope
1Department of Otolaryngology-Head and Neck Surgey, Temple University Hospital, Philadelphia, Pennsylvania, USA.
Abstract:
Since the inception of the flexible nasopharyngolaryngoscope, sterility has been a primary concern. The increased incidence of hepatitis, tuberculosis, and acquired immunodeficiency syndrome has raised the fear of cross-contamination. Sterilization requires the use of ethylene oxide, which is economically disadvantageous, forcing most practitioners to disinfect rather than sterilize their nasopharyngolaryngoscopes. A presterilized, disposable sheath was designed in 1993. The system was cumbersome, because it required an air pump. Thus, it was not adopted by the majority of physicians. As a result, the manufacturer developed a new system, which I evaluated. It is cost-effective, smoother-surfaced, 70% thinner-walled, and much simpler to use. The disposable, single-use sheath is sterile, with no need for a pump or any additional device, and can be used anywhere at any time. I believe it will become the standard method for sterile introduction of the nasopharyngolaryngoscope.
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