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Updated: Aug 26, 2025

Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes
Published on: August 2, 2024
A test prototype of a novel flexible video laryngoscope and preliminary verification in a difficult airway management
Fei Xu1, Chang Liu1, Yang Zhou1
1Department of Anesthesiology, Peking University Third Hospital, Beijing, 100191, China.
Background:
To verify a test prototype of a novel flexible video laryngoscope in a difficult airway management simulator and to compare the efficacy of the flexible video laryngoscope with that of a conventional video laryngoscope.
Methods:
Fifteen clinical anesthesiologists performed endotracheal intubation with a flexible video laryngoscope and a conventional video laryngoscope in a difficult airway management simulator in the neutral position with intermediate and difficult mouth opening. The rate of intubation success, intubation time, and classification of glottic exposure were recorded. After endotracheal intubation, participants were asked to assess the difficulty of intubation of the two laryngoscopes.
Results:
The success rate of endotracheal intubation with flexible video laryngoscope was significantly higher than that with video laryngoscope in neutral positions with both intermediate (P = 0.025) and difficult (P = 0.005) mouth opening. The Cormack Lehane score of the flexible video laryngoscope was significantly lower than that of the video laryngoscope in the neutral position with intermediate mouth opening (P < 0.001) and difficult mouth opening (P < 0.001). There was no significant difference in intubation time in the neutral position with intermediate mouth opening (P = 0.460) or difficult mouth opening (P = 0.078). The difficulty score of endotracheal intubations with the flexible video laryngoscope was also significantly lower than that of the video laryngoscope in the neutral position with intermediate mouth opening (P = 0.001) and difficult mouth opening (P = 0.001).
Conclusions:
Compared with conventional video laryngoscopy, flexible video laryngoscopy can provide superior glottic exposure and improve the success rate of intubation in a difficult airway management simulator.
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