Pitfalls and problems in flexible fiberoptic videolaryngoscopy

The flexible fiberoptic laryngoscope is a valuable tool in the examination of laryngeal and supraglottic structure and function. Nevertheless, persistent questions remain about the validity of the perceived image, and a variety of concerns arise relative to the equipment used, the difficult to examine patient, and the difficulty in obtaining measurable objective data. All of these areas are discussed. Distortions of the video image that result from the wideangle lens effect are described. Given an awareness of the distortions that may be present in the fiberoptic video image, it is clear that it is necessary to exercise caution in making judgments of anatomic or physiologic integrity based on fiberoptic information alone.