Fiberoptic Nasopharyngolaryngoscopy

Obstruction of the nasal airway, pharynx, and larynx can all be visualized during fiberoptic exam. In particular, the larynx can be more closely observed for such

FIGURE 1 (See color Insert.) Fiberoptic laryngoscopy. Note that the entire vocal folds of the normal larynx can be visualized (left). Mullens maneuver results in velopharyngeal and hypopharyn-geal collapse with airway obstruction. Vocal folds are obscured by soft tissue in this abnormal exam (right). Abbreviation: OSA, obstructive sleep apnea.

FIGURE 1 (See color Insert.) Fiberoptic laryngoscopy. Note that the entire vocal folds of the normal larynx can be visualized (left). Mullens maneuver results in velopharyngeal and hypopharyn-geal collapse with airway obstruction. Vocal folds are obscured by soft tissue in this abnormal exam (right). Abbreviation: OSA, obstructive sleep apnea.

abnormalities as an omega-shaped epiglottis, vocal fold paralysis or obstructing lesions. Evaluation of the posterior airway space (PAs) is required to determine if obstruction occurs at the palate and/or tongue base. Furthermore, the posterior airway space is examined at rest as well as during provocative maneuvers. One such technique, Muller's maneuver, has been evaluated by Sher et al. (30) to identify potential sites of obstruction and to predict surgical success. This test involves inspiration against a closed oral and nasal airway, while keeping the glottis open. Photo documentation of findings may prove useful for surgical planning and patient education (Fig. 1).

Fiberoptic examination is not only important to evaluate the upper airway for obstruction but aids in determining ease of intubation. These data can be invaluable to both the surgeon and anesthesiologist, as they determine the best method to intu-bate a patient.

Sleep Apnea

Sleep Apnea

Have You Been Told Over And Over Again That You Snore A Lot, But You Choose To Ignore It? Have you been experiencing lack of sleep at night and find yourself waking up in the wee hours of the morning to find yourself gasping for air?

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