Combined Techniques in Difficult Airway Management

Difficult or failed tracheal intubation is an important cause of mortality and morbidity. Approximately 30% of anesthesiarelated deaths are caused by the complications of difficult airway management. Also, 85% of respiratory complications result in brain damage or death [1]. Awake tracheal intubation is the most appropriate method for protection of airway reflexes in patients, who are expected or known to have difficult intubation. However, the use of video laryngoscope in awake patients in a way similar to the use of classic direct laryngoscope, which requires hanging of epiglottis or the use of fiber optic bronchoscope through nose, disturbs patients and complicates the procedure by causing gag reflex and mucosal bleeding.