Communication Paradox in Shared Airway Management: A Multicenter Survey

To assess communication practices, perceived barriers, and collaborative attitudes among anesthesiologists in shared airway scenarios, and quantify the gap between perceived value and actual utilization of interdisciplinary airway information.

Multicenter cross-sectional survey of anesthesiology residents and specialists at four Israeli tertiary medical centers (January-February 2026). Outcome measures included frequency of seeking otolaryngologic input, perceived usefulness, barriers to utilization, and attitude-behavior correlations across three scenarios: impending airway obstruction, elective direct microlaryngoscopy, and trauma-related airway management.

Of 165 eligible anesthesiologists, 152 responded (93%). Otolaryngologic input was rated very helpful or essential by 68.4% in impending obstruction and helpful by 47.4% in trauma, yet 25.7% and 41.4% rarely or never sought it, respectively. In elective cases, 43.4% rarely or never reviewed preoperative otolaryngology flexible laryngoscopy video recordings, despite 28.9% expressing concern about iatrogenic vocal fold injury. Perceived value correlated only moderately with utilization (Spearman ρ = 0.27-0.58, all p < 0.001). Primary barriers were systemic: inconsistent otolaryngology recording, incompatible electronic systems, and time constraints. Specialists rated otolaryngologic input and training more favorably than residents (p < 0.05). Support for joint simulation-based training was near-unanimous (90.8%).

Anesthesiologists consistently value otolaryngologic input but frequently fail to utilize it due to systemic rather than attitudinal barriers. Structural interventions, including EMR-integrated airway data, standardized perioperative briefings, and joint simulation training, are needed to bridge this gap.