Combined Video Laryngoscope and Fiberoptic Nasal Intubation

Techniques for facilitating nasal intubation and reducing associated airway trauma are well documented in the literature. This case series describes an additional technique that combines the use of the video laryngoscope and fiberoptic bronchoscope for intubation. Rather than first starting with the fiberoptic bronchoscope, an endotracheal tube is passed through the nasopharynx and lined up with the glottis using video laryngoscopy. Subsequently, the fiberoptic bronchoscope is used only to guide the endotracheal tube through the glottis. The two perspectives simultaneously provide enhanced guidance to the operator, which can, in turn, reduce the burden of fiberoptic navigation through blood, secretions, and/or altered airway anatomy. Additionally, our report demonstrates that this procedure can be used as a rescue measure when Magill forceps are unsuccessful.