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TECHNOLOGY, COMPUTING, AND SIMULATION

The Novel Use of Computer-Generated Virtual Imaging to Assess the Difficult Pediatric Airway

Warwick A. Ames, MBBS, FRCA, David B. Macleod, MBBS, FRCA^*, Allison K. Ross, MD, Jeffrey Marcus, MD, and Srinivasan Mukundan, Jr, MD, PhD

From the *Department of Anesthesia; Division of Pediatric Anesthesia, Duke University Medical Center, Durham, North Carolina 27710; Department of Pediatric Plastic Surgery and Craniofacial Surgery; and Division of Medical Physics, Department of Neuroradiology.

Address correspondence to Warwick A. Ames, MBBS, FRCA, Division of Pediatric Anesthesia, Duke University Medical Center, Box 3094, Durham, North Carolina. 27710. Address e-mail to ames0002{at}mc.duke.edu.

In a patient with a known difficult airway, history and examination may be of limited use in formulating a management plan for subsequent tracheal intubation. Further detailed and descriptive review of the airway is necessary. Virtual imaging is a recent advance in radiology that offers noninvasive airway assessment. It creates a movie clip image of the upper airway akin to the view obtained through a fiberscope. We present a patient with Goldenhar syndrome in whom virtual imaging was used to identify the cause of a previous failed tracheal intubation.

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