Styletubation: A Video Intubating Stylet Technique for Endotracheal Intubation

Management of the upper airway and endotracheal intubation are provided by a variety of specialists including anesthesiologists, otorhinolaryngologists, emergency physicians, and pulmonary physicians. Fibreoptic and video technologies are widely used for airway management. Optical stylets, which incorporate flexible fibreoptic imaging elements in an intubation stylet, are gradually becoming the preferred intubation tools for a growing number of specialists. The ideal optical stylet should provide illumination and an image of high clarity, familiar handling with malleability and additional tip flexion, and low cost so that it becomes available to the larger community of airway providers.

The Shikani Optical stylet (SOS) was introduced in 1999 as a novel intubating stylet which has a lens at the distal end, a fiberoptic cable inside and is connected to a camera and a video monitor, hence allowing continuous visualization of the airway during introduction of the tube into the glottis [Shikani AH. New ＂seeing＂ stylet-scope and method for the management of the difficult airway. Otolaryngol Head Neck Surg. 1999 Jan;120(1):113-6. doi: 10.1016/S0194-5998(99)70380-3.]. The SOS allowed the introduction of the Shikani technique for intubation (Styletubation), which allows endotracheal intubation without the need of the rigid laryngoscope blade to retract the base of the tongue, hence minimizing the risk of trauma to the glottis or dentition. The SOS and Shikani technique for intubation (Styletubation) have been used in millions of patients worldwide (mainly in Asia), published in more than 100 articles and cited in many more.

This book is a review of our clinical experience with optical stylets, with the Shikani Optical stylet and the Shikani technique for intubation (Styletubation). In this monograph (volume 1), we collected several published articles covering several topic as follows.

 Chapter 1─Chapter 5: The history and development of styletubation

 Chapter 6─Chapter 8: The technical pearls and tips of styletubation

 Chapter 9─Chapter 14: The role of styletubation in various difficult airway scenarios

 Chapter 15─Chapter 20: The role of styletubation during COVID-19 pandemic

The authors also wish to acknowledge the contribution made by publishers who accomplish the knowledge sharing of the publications we presented in this monograph. The book has been written expressly for the providers with a solid background in airway management, in order to serve as a reference while they accumulate additional experience in intubation. Experience is the best teacher in airway management.

It is our intention to provide basic, practical and tested maneuvers to manage the airway in the real world. Our contribution to this book is to share the result of personal experience gained over many years of clinical practice. It is a statement earned by personal observation, building upon the knowledge of those who taught us.

Alan H. Shikani, MD, FACS

About Hsiang-Ning Luk, MD, MS, PhD, CIP

●Education:

MD National Defense Medical Center, Taiwan

MS Pharmacology, National Defense Medical Center, Taiwan

PhD Physiology, Leuven University, Belgium

CIP Certified IRB Professional, CCIP, USA

●Academic Position:

National Defense Medical Center, Taipei

National Yang-Ming University, Taipei

National Taipei Nursing College, Taipei

Chang Gung University, Linkou

Chung Shan Medical University, Taichung

Catholic Providence University, Taichung

...