Direct laryngoscopy assisted fiberoptic intubation: A novel technique for the pediatric airway

Int J Pediatr Otorhinolaryngol. 2020 Oct;137:110232. doi: 10.1016/j.ijporl.2020.110232. Epub 2020 Jul 10.


Objective: To introduce a novel intubation technique for difficult pediatric airways.

Methods: This two-provider technique requires a direct laryngoscope and a flexible fiberoptic laryngoscope. One provider performs direct laryngoscopy which allows for introduction of the flexible laryngoscope. The second provider inserts the flexible laryngoscope with the endotracheal tube loaded, through the oropharynx in to the subglottis.

Results: We report three pediatric patients that were initially unable to be intubated by conventional methods. We were ultimately able to successfully intubate these patients with difficult airways using our novel technique.

Conclusions: We found that this technique of direct laryngoscopy assisted flexible fiberoptic intubation is a useful adjunct in select pediatric difficult airway patients.

Keywords: Direct laryngoscopy; Intubation; Pediatric airway.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Female
  • Fiber Optic Technology*
  • Humans
  • Infant
  • Infant, Newborn
  • Intubation, Intratracheal / instrumentation
  • Intubation, Intratracheal / methods*
  • Laryngoscopes*
  • Laryngoscopy / instrumentation
  • Laryngoscopy / methods*