Anesth Analg 2009 Jun; 108(6):1937-40

When fiberoptic intubation fails in patients with unstable craniovertebral junctions.

Maktabi MA, Titler SS, Kadakia S, Conway RK

Abstract
Fiberoptic intubation (FOI) is generally regarded as the preferred method to achieve endotracheal intubation in patients with cervical spine instability. When performed electively, FOI has a very high level of success. Nevertheless, rarely, FOI may fail. Recently, using the fiberoptic scope to obtain a view of the glottis, with the endotracheal tube being inserted independently, guided by the fiberoptic view has been described. In this report, we describe our experience with a variation of this technique in both adults and children with occipito-cervical instabilities in whom FOI failed.