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Bedside laryngeal visualization is transforming how intensivists manage airway complications in the intensive care unit. After prolonged endotracheal intubation, patients often suffer from laryngeal dysfunction, including impaired vocal fold motion. These issues frequently complicate core respiratory therapy tasks like cough evaluation. Consequently, clinicians need precise tools to evaluate vocal fold motion and secretion pooling. Specifically, transnasal fiberoptic laryngoscopy (TFL) offers a direct view of the airway to identify mucosal trauma and aspiration risks.
In addition, translaryngeal ultrasound (TLU) serves as an efficient and accessible screening method for laryngeal health. These tools enable personalized airway clearance strategies that significantly improve patient recovery. Furthermore, TFL ensures the correct placement of suction catheters in difficult cases where blind attempts fail. Implementing these techniques requires structured local training and strict adherence to infection-prevention protocols. However, the diagnostic value they add in challenging cases enhances both clinical safety and workflow efficiency. Therefore, hospital pathways should integrate these visualization modalities for high-risk critically ill patients.
It allows clinicians to directly observe vocal fold movement and airway patency. By visualizing the laryngeal response during a cough, therapists can tailor airway clearance techniques to the patient's specific physiological needs.
TLU is noninvasive, highly accessible, and can be performed quickly at the bedside. It helps identify patients with suspected laryngeal dysfunction early, allowing for targeted follow-up with more invasive TFL assessments when necessary.
Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.
References
Ntoumenopoulos G et al. Scope and Scan Led Airway Care: Therapist Laryngeal Visualization. Respir Care. 2026 May 02. doi: 10.1177/19433654261444706. PMID: 42068205.
Brodsky MB, et al. Laryngeal Injury and Upper Airway Symptoms after Oral Endotracheal Intubation with Mechanical Ventilation During Critical Care: A Systematic Review. Crit Care Med. 2018.
Seder DB, et al. The Role of Bedside Laryngeal Ultrasound in Critical Care. Journal of Intensive Care Medicine. 2023.
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