To the Editor:--In a recent article describing the results of teaching fiberoptic intubation, [1]I was quite surprised regarding a comment that “mechanical aids are not applicable in an awake intubation situation.” Oral obturators are in widespread use in the United States and are frequently described in the literature, including their first reference. [2]Although there are no studies that support the advantages of these devices over simple tongue retraction, the hypothetical advantages of providing a secretion-free conduit to pass the scope, helping the endotracheal tube to negotiate the turn necessary for oral insertion into the glottis, protection from inadvertent dental damage, and, especially, biting the scope by the awake patient, certainly make a compelling argument for their use.

Thaddeus J. Krensavage, D.O., Staff Anesthesiologist, Morton Hospital and Medical Center, Taunton, Massachusetts 02780.

(Accepted for publication July 2, 1996.)

Cole AFD: Fiberoptic intubation using anesthetized, paralyzed, apneic patients. ANESTHESIOLOGY 1996; 84:1101-6.
Benumof JL: Management of the difficult adult airway. ANESTHESIOLOGY 1991; 75:1087-110.