Kinking of Disposable Fiberoptic Bronchoscope During Difficult Nasal Awake Intubation

Background: disposable fiberoptic for intubation are more and more available in operating room We hereby report a complication of a difficult fiberoptic intubation performed with a disposable fiberscope. Case: Under remifentanil sedation Visualizing the glottis was easy while advancing the endotracheal tube through the fiberscope was mildly difficult. Removing the fiberscope was impossible as was the removal of the endotracheal tube. The patient was becoming uncomfortable. Under local anesthesia we performed a jet ventilation after puncture of the cricothyroid membrane followed by total intravenous anesthesia. A cervicofacial surgeon visualized the kinking of the fiberscope at the tip of the endotracheal tube. The fiberscope was removed under direct vision with a rigid bronchoscope. Conclusion: Because of more flexibility disposable fiberscopes may kink during the introduction of the endotracheal tube.