Rigid nasendoscope with video camera system for intubation in infants with Pierre-Robin sequence

We describe an alternative intubation technique using a rigid nasendoscope and a video camera monitor system in two infants with Pierre-Robin sequence presenting for palatoplasty. After induction with an inhalational anaesthetic technique, the tracheas of the infants could not be intubated with direct laryngoscopy using a Wisconsin blade. In the absence of a flexible paediatric fibrescope, a rigid endoscope (2.7 mm, 70 degrees lateral illumination) was passed orally to provide a view of the glottis on the monitor screen. A tracheal tube, bent into a J-shape using a stylet, was inserted orally and manipulated into the trachea, under video guidance. This technique proved to be simple, permitting a favourable view of the glottis. It should be considered for passing a tracheal tube through the vocal cords in infants who present with a difficult airway.