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Related Experiment Video

Updated: Jun 16, 2026

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation

Published on: August 2, 2024

Awake upper airway surgery.

Paolo Macchiarini¹, Irene Rovira, Sante Ferrarello

¹Department of General Thoracic Surgery, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain. pmacchia@thoraxeuropea.eu

The Annals of Thoracic Surgery

|January 28, 2010

Summary

This summary is machine-generated.

Awake and tubeless airway surgery for stenosis is feasible and safe, offering high patient satisfaction. This approach may transform surgical and anesthetic strategies for airway stenosis procedures.

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Published on: December 6, 2016

Area of Science:

Otolaryngology
Thoracic Surgery
Anesthesiology

Background:

Airway surgery presents a clinical challenge in balancing surgical and anesthetic access.
Investigating awake anesthesia with spontaneous respiration for upper airway procedures is crucial.

Purpose of the Study:

To determine the feasibility of performing upper airway surgery under awake anesthesia and spontaneous respiration.
To evaluate the safety and efficacy of a novel approach to airway stenosis surgery.

Main Methods:

A prospective feasibility study involving patients with upper tracheal stenosis.
Cervical epidural anesthesia, conscious sedation, and atomized local anesthetic were employed.
No intraoperative intubation or jet ventilation was required; outcomes included surgical ease, functional results, complications, and patient satisfaction.

Main Results:

Twenty patients with subglottic or upper tracheal stenosis underwent surgery (resections and primary anastomosis).
The procedure was well-tolerated, with most patients able to cough, talk, swallow, and mobilize quickly post-surgery.
No early complications were observed, with excellent functional outcomes and high patient satisfaction (median 9.5/10).

Conclusions:

Awake and tubeless upper airway surgery is a feasible and safe option for treating airway stenosis.
The high patient satisfaction suggests this method could significantly alter current surgical and anesthetic practices.
Further support from randomized controlled trials is warranted to solidify this approach.