To the Editor:

—I read with great interest the letter by Aoyama et al. , “Simple Modification of the Ovassapian Fiberoptic Intubating Airway.”1They make the point that applying the black line on the backside of the airway helps to confirm the midline placement of the fiber-optic bronchoscope. We have been using this marking system for another reason. If the backside of the airway is not marked, the fiber-optic bronchoscope may inadvertently be passed through one of the two holes in the airway. This error will only be realized later when the bronchoscope is advanced and an attempt is made to advance the endotracheal tube over the fiber-optic bronchoscope (fig. 1). As the bronchoscope is advanced between the intubating airway and the palate, the black marking is identified. This marking helps to identify the midline placement of the bronchoscope and to make sure that the bronchoscope has not passed through one of the holes. If the bronchoscope passes through one of the holes, the black line will not be

Fig. 1. Shows the passage of the fiber-optic bronchoscope through one of the holes of the Ovassapian fiber-optic intubating airway.

Fig. 1. Shows the passage of the fiber-optic bronchoscope through one of the holes of the Ovassapian fiber-optic intubating airway.

identified.

1.
Aoyama K, Seto A, Takenaka I: Simple modification of the Ovassapian fiberoptic intubating airway. Anesthesiology 1999; 91:897