We talk with Laura Matrka MD and Mark Gerber MD about their approaches to airway surgery, including endoscopic vs open, tips on technique, and the importance of communication in the OR.

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SHOW NOTES

In this episode, Dr. Laura Matrka and Dr. Mark Gerber join Dr. Romaine Johnson and Dr. Gopi Shah to discuss airway surgery.

The evaluation of adult and pediatric patients requiring airway surgery is outlined. Key components include a thorough flexible scope exam, direct laryngoscopy/bronchoscopy and a detailed airway history. Deciding between an endoscopic and open approach depends on several factors including airway anatomy, surgical history, acuity of the procedure, and presence of a tracheostomy.

Dr. Matrka and Dr. Gerber review essential equipment for airway surgery - their “airway toolbox” – which can include a subglottic scope, bronchoscope, tracheoscope, or a drill depending on the extent of their procedure. The discussion then turns towards the selection of suture between PDS and Prolene. Dr. Johnson states that he has had less wound dehiscence, but more granulation tissue when using PDS as compared to Prolene.

Lastly, the panel describes technological improvements they would like to see in the coming years. All agree that new approaches to visualize what trainees are observing would significantly improve education and patient care. The panel concludes by discussing the importance of communication in the operating room, and the benefit of protocols in facilitating effective teamwork.

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RESOURCES

American Society of Pediatric Otolaryngology: https://aspo.us

Communication Protocol for Airway Surgery from Dr. Matrka and colleagues: https://onlinelibrary.wiley.com/doi/abs/10.1002/lary.28271