Air-splinting Maneuver During Flexible Bronchoscopy: A Cross-sectional Study

Area of Science:

• Medical procedures
• Respiratory system anatomy
• Airway management

Background:

• Flexible bronchoscopy requires clear upper airway access.
• Luminal closure at the nasopharynx-oropharynx junction can impede insertion.
• Magazine's maneuver was designed to overcome this obstruction.

Purpose of the Study:

• Determine the frequency of upper airway luminal closure during bronchoscopy.
• Evaluate the effectiveness of Magazine's maneuver compared to other techniques.
• Improve visualization during flexible bronchoscopy.

Main Methods:

• 443 adult patients undergoing flexible bronchoscopy were enrolled.
• Transnasal approach used; lumen patency assessed at nasopharynx-oropharynx junction.
• Four maneuver variations tested, including Magazine's maneuver.

Main Results:

• Baseline obstruction occurred in 23.7% of subjects.
• Nose/mouth breathing opened the lumen in 66.4%; head-tilt improved to 68.4%.
• Magazine's maneuver achieved 100% lumen patency.

Conclusions:

• Magazine's maneuver is highly effective in opening the nasopharynx-oropharynx junction.
• Standard breathing techniques are less effective for maintaining airway patency.
• Head-tilt maneuvers offer no significant additional benefit over breathing techniques.