Airway difficulties are a major concern for anesthesiologists. Even though fiberoptic intubation is the generally accepted method for management of difficult airways, it is not without disadvantages-requires patient cooperation, and cannot be performed on soiled airway or upper airways with pre-existing narrowing pathology. Additionally, fiberoptic bronchoscopy is not available at every medical...

Communications to the Editor pulmonary toilet is often ineffective in clearing patients of these molasses-like secretions. Sputum retention should be considered in these presentations: COPD with frequent exacerbations requiring intermittent or chronic steroid therapy, slowly resolving pneumonia (particularly associated with debilitation), COPD or surgery, and intubated patients with thick secre...

Intratracheal combustion of a fiberoptic bronchoscope and an endotracheal tube occurred during the treatment of severe tracheal stenosis with the neodymium-YAG laser. This recognized hazard of CO2 laser surgery has not been reported previously with the use of the Nd-YAG laser. Fire hazard is inevitable when a laser is used in the airway, but the risk can be diminished. Rapid removal of the burn...

Endoscopic sinus surgery performed on a healthy young male could have resulted in a fatal outcome when a surgically placed nasal pack became dislodged upon extubation and unknowingly was aspirated. Unlike the "missing" nasal packs or posterior pharyngeal packs placed intraoperatively, this particular pack was to remain in place 12 to 24 hours postoperatively, status postseptoplasty. At the conc...

In a double-blind study the fiberoptic bronchoscope was contaminated with five pathogenic organisms, each at a concentration of 10(9) organisms per milliliter. The shaft and inner channel of the bronchoscope were cleansed with five antiseptic regimens. Each regimen included equal 120-ml aliquots of one, two, or three solutions, respectively. The five different regimens were as follows: (1) phys...

OBJECTIVE To describe our technique and experience of treating adult subglottic stenosis using the Nd:YAG laser through a flexible bronchoscope via a fiberoptic delivery system. DESIGN Retrospective chart review. PATIENTS This study included 16 patients with subglottic stenosis who presented to the senior surgeon (M.R.R.) for laser bronchoscopy from January 2000 to December 2006. MAIN OUT...