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The flexible optical bronchoscope has unparalleled utility for difficult airway management and is part of every difficult airway management algorithm. The device can facilitate intubation for patients with airway tumours and bony or soft tissue abnormalities. It provides continuous visualisation of the airway during management, can be used to deliver local anaesthetics to the airway and is relatively less traumatic compared to other devices. Mastery of the device requires significant practice and the practitioner must use the device regularly to maintain skills. Several tips for success and pitfalls to be avoided are discussed.
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