title: Virtual endoscopy--a new assessment tool in difficult airway management.
abstract: Preemptive mapping of the airway is a useful adjunct to conventional clinical assessments when airway management planning for patients with complex head and neck pathology. Nasendoscopy is frequently used for this purpose but is also invasive and poorly tolerated in a subset of patients and, even in expert hands, may not allow complete visualization of the glottis and subglottic structures. We present a novel tool for difficult airway management planning in the form of virtual endoscopy by applying free online OsiriX software to head and neck computed tomographic scans to generate a "fly-through" airway reconstruction. To highlight how well virtual endoscopy correlates to conventional fibreoscopy, we compare both of these assessment tools in 3 patients with glottic, subglottic, and multilevel airway pathologies. Virtual endoscopy represents a unique, noninvasive, safe, and accurate airway assessment and educational resource, which warrants further exploration.
authors.affiliation: Department of Anaesthesia, Guy's Hospital, Great Maze Pond, SE1 9RT, London, United Kingdom.. Electronic address: drimranahmad1@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Ahmad
authors.affiliation: Department of Anaesthesia, Guy's Hospital, Great Maze Pond, SE1 9RT, London, United Kingdom.
authors.forename: B
authors.initials: B
authors.lastname: Millhoff
authors.affiliation: Department of Anaesthesia, Guy's Hospital, Great Maze Pond, SE1 9RT, London, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: John
authors.affiliation: Department of Maxillofacial Surgery, St George's Hospital, Blackshaw Rd, SW17 0QT, London, United Kingdom.
authors.forename: K
authors.initials: K
authors.lastname: Andi
authors.affiliation: Department of Ear, Nose and Throat, Guy's Hospital, Great Maze Pond, SE1 9RT, London, United Kingdom.
authors.forename: R
authors.initials: R
authors.lastname: Oakley
mesh_terms: D000328:Adult; D058109:Airway Management / Q000295:instrumentation* / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005336:Fiber Optic Technology; D005931:Glottis / Q000473:pathology; D014890:Granulomatosis with Polyangiitis / Q000601:surgery; D006257:Head / Q000033:anatomy & histology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008342:Mandibulofacial Dysostosis / Q000150:complications; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology; D037981:Neck Dissection; D012984:Software; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface
keywords: Airway management; Computed tomography; Endoscopy