For intubation of patients with known or anticipated airway abnormalities, the flexible fiberoptic bronchoscope is an invaluable tool. It also may be useful in patients whose airway abnormalities are unrecognized on preintubation assessment. In some instances, however, even fiberoptic intubation may fail or prove difficult. Thus, alternatives to the fiberoptic bronchoscope have been developed. A number of these, including the laryngeal mask airway (LMA) designed in 1981 by Dr. Archie Brain, have been discussed.

In many cases fiberoptic bronchoscopy can be augmented with a laryngeal mask airway to improve the intubation success rate. Use of this technique also provides a means of ventilation and oxygenation during the intubation. In conjunction with the FOB, the LMA can be used in the management of the unanticipated difficult airway or to facilitate intubation in the known or suspected difficult airway.