A comparison of fiberoptic-compatible oral airways

Fiberoptic-compatible oral airways (FCOAs) combine the simplicity and benefits that traditional oral airways provide, with the advantage of mechanically guiding fiberoptic intubation. This review examines and compares the salient properties of these devices. Of note, the clinician should pay particular attention to the location and depth of the channel. FCOAs, with an anterior channel, may be advantageous for use with difficult intubations arising from an excessively anterior-oriented glottis, whereas a channel with excessive depth may hinder the localization of a glottis which is off-midline. In certain circumstances, channel size will limit tracheal tube size. The intubating Laryngeal Mask Airway (iLMA) is also included in this comparison. Although this device may have an advantage in performing blind intubations, its use, even with a fiberscope, may be limited. This limitation applies to intubations in which mouth opening is restricted, the glottis is off-midline, airway tumors are present, or with the presence of prior cervical radiotherapy. Furthermore, because of its size, the iLMA can potentially cause airway trauma, which could subsequently limit the utility of a fiberscope. In addition, the FCOA can generate greater positive-pressure ventilation, when used with a tight-fitting face mask, than the iLMA. FCOAs offer clinicians the ability to visualize airway anatomy while allowing straightforward access for tracheal intubation.