DOI: 10.1213/00000539-200202000-00058
,
Issn Print: 0003-2999
Publication Date: 2002/02/01
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Excerpt
We appreciate the interest and comment expressed by Drs. Chou and Wu regarding our article (1). We agree with them that difficulty with tracheal intubation is a major concern for anesthesiologists. In our opinion, there are two approaches to resolve this problem. One method is a preoperative prediction of potential difficulty with endotracheal intubation. For this purpose, several clinical criteria, including the Mallampati classification and MHD (2,3), have been used to assess patients before anesthesia. However, none of these methods can fully predict difficult intubation. Second approach is a strategy to manage the unanticipated difficult airway. We believe the second approach is more important and should be preformulated and practiced by every anesthesiologist.
For a difficult endotracheal intubation, numerous fiberoptic-intubating aids have been used (4). However, the need for special instruments and skills to use these techniques limits to become a standard method. Unfortunately, we have no experience with the use of the WuScope. Therefore, we cannot comment whether the WuScope is useful in a patient with a long and narrow retropharyngeal air space. Although the usefulness of the WuScope has been reported in difficult airway problems (5), several disadvantages including a large cost, the introduction of new cleaning and disinfecting routines, and the requirement for leaning and mastering new skills should be considered (6). Our two-person technique does not require any additional device except for the conventional laryngoscope and the fiberoptic bronchoscope.
