Innovative use of fibreoptic bronchoscope as a flexible, manoeuvrable stylet during C-MAC videolaryngoscopy

Abstract

The C-MAC videolaryngoscope has been used along with bougies, pliable metal stylet and optical stylet during the management of the difficult airway. The fibreoptic bronchoscope (FOB) was used as a last resort in our patient to direct the endotracheal tube into the trachea. A 74-year-old male (American Society of Anesthesiologists Physical Status III) who had undergone cervical spine instrumentation 12 years prior was scheduled for laparoscopic prostatectomy. On examination, he was found to have restricted neck movements. In view of the anticipated difficult airway, awake fibreoptic intubation was planned, for which the patient did not give consent. A FOB with a preloaded endotracheal tube was used as a flexible stylet. The fibrescope was manoeuvred towards the glottis which was visualised with the help of the C-MAC videolaryngoscope, resulting in successful intubation.