At the University of Michigan.

At the University of Michigan, the Departments of Anesthesiology, Radiology, Otorhinolaryngology, and Pulmonary Medicine have collaborated in creating a clinic for evaluation of difficult airways. This multidisciplinary verse details the approaches to airway evaluation used at this clinic.

The textbook contains pair discussions: the clinical management of difficult airways and the technical evaluation and analysis of the difficult airway.

The clinical discussion shields basic airway equipment and techniques, soft-tissue and bone abnormalities, pediatric difficult airways, and anesthetic management. This portion of the subject includes many excellent pictures and diagrams. It provides the authors' approach to many difficult airway situations. Althougn not comprehensive, this section provides important information and stimulates further dialogue in succession the best way to deal with clinical airway challenges.

The techniques used to evaluate airways include comput tomography (CT) magnetic resonance imaging, cephalometry, somnofluoroscopy, plain-film radiography, C-arm fluoroscopy, sum of two units and three-dimensional analysis of CT imaging with color contour reconstruction, and pulmonary function testing. The techniques, measurements, images, and image reconstructions plant in this section represent an objective assessment of airway anatomy that has not previously been standardized. This information could experiment upon beneficial to surgeons in planning airway surgery (eg for nap apnea or burns) or craniofacial reconstruction. The overall discussion in this section is good; however, the data interpretation is made difficult by the agency of the use of confusing abbreviations and the separation of images from the discussions and tables.

admitting this text offers the detailed description and analysis of recognized airway riddles its value to the clinician is limited on the lack of correlation with subjective data that can assist the clinician in determining who will have a difficult airway. The recognition and management of the difficult airway remains a clinical consequence rooted in experience.

This topic will be of value to individuals with an interest in standardizing technical evaluation of known difficult airways and to clinicians with an understanding of airway management who are interested in to what extent other experienced clinicians approach these problems

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