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Techniques for Nasal Intubation

Laryngoscopy Video Anatomy

RML wearing Airway camMany options exist for imaging the larynx from an intra-oral perspective (endoscopes, video laryngoscopes, stroboscopes, etc.). For teaching and researching direct laryngoscopy, capturing the perspective of the operator is very useful. Textbooks in anesthesia, emergency medicine, EMS, ACLS, and other references that teach intubation and emergency airway management have historically not included any imaging of direct laryngoscopy because there has been no method of obtaining this type of image. Shooting a photograph from outside the mouth and down the throat at the larynx is very challenging due to lighting and focal distance problems. For much of the modern era it was mistakenly believed that direct laryngoscopy was a binocular procedure. During efforts at imaging direct laryngoscopy, Dr. Levitan determined that the larynx is sighted monocularly. Imaging of direct laryngoscopy from the perspective of the operator requires placing a camera within the line of sight of the dominant pupil.

 

The Airway Cam (TM) Direct Laryngoscopy Video System (Airway Cam Technologies, Inc., Wayne PA), was invented in 1994 by Dr. Levitan as a resident in emergency medicine at Bellevue Hospital in NYC.  It uses a head-mounted miniature video camera that has been optically aligned with the dominant pupil. Sighting of the larynx is done through a beam-splitting penta-prism wedge assembly.

 

airway can images V#

 

The interarytenoid notch is visible as a thin vertical cleft between the rounded prominences of the posterior cartilages.The interarytenoid notch marks the most posterior aspect of the laryngeal inlet. Above this notch is the glottic opening and below this landmark is the upper esophagus.

 

straight airway cam images

 

Airway Cam imaging of straight blade laryngoscopy (Wisconsin blade, from top left to bottom right) demonstrating the epiglottis, tilting the blade forward and advancing beneath the epiglottis edge, exposure of posterior cartilages and esophagus, and ultimately an excellent view of the glottic opening and true vocal cords.

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DISCLAIMER:  The procedures discussed at this website, to be performed properly, rely on complex medical skills and should only be undertaken after formal instruction and hands-on clinical training with appropriate supervision, and after receiving professional certification and authorization to do so. The content presented herein is meant to serve as just one of many resources that trainees and health care professionals should consult in the course of the their skill acquisition and ongoing practice. Airway Cam Technologies, Inc., its authors, officers, agents and assigns, disclaim any and all responsibility for any adverse outcomes and or harmful acts committed by others persons who may have consulted this website or relied on information contained herein.

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