To the Editor:
In their editorial, Drs. Fiadjoe and Litman1
refer to the protracted learning curve of fiberoptic intubation in contrast to video laryngoscopy. This difference applies primarily to clinicians experienced in direct laryngoscopy but not in fiberoptic intubation. Beginning residents may find fiberoptic intubation easier to learn than video laryngoscopy, achieving a higher success rate with less trauma sooner with fiberoptic intubation than direct laryngoscopy and subsequent video laryngoscopy.2
Training programs neglecting proficiency in fiberoptic intubation in favor of extensive experience with direct laryngoscopy may generate the graduates described by Drs. Fiadjoe and Litman. However, trainees graduating with proficiency in fiberoptic intubation and video laryngoscopy who continue to practice both make the comparison of academic interest only.
In summary, the observation by Drs. Fiadjoe and Litman regarding fiberoptics and video laryngoscopy may reflect differences among training programs rather than between the two techniques themselves.
Samuel Metz, M.D.,* Tracey Straker, M.D.
*Oregon Anesthesiology Group, Portland, Oregon. firstname.lastname@example.org
1. Fiadjoe JE, Litman RS. Difficult tracheal intubation: Looking to the past to determine the future. ANESTHESIOLOGY. 2012;116:1181–2
2. Pott LM, Randel GI, Straker T, Becker KD, Cooper RM. A survey of airway training among U.S. and Canadian anesthesiology residency programs. J Clin Anesth. 2011;23:15–26
© 2013 American Society of Anesthesiologists, Inc.