Anesthesiology NewsWill We Abolish the ‘Difficult’ Airway?

🎓 Expert Commentary / Peer Perspective

An airway-management commentary examines whether the longstanding concept of the difficult airway should be replaced by airway complexity. The discussion argues that difficulty reflects the clinician experience while complexity reflects the underlying system and patient factors.

Clinical Considerations

• Difficulty reflects operator experience, technical skill, cognitive load, fatigue, and situational factors.
• Complexity reflects interacting physiologic, anatomic, environmental, and team-based variables independent of operator expertise.
• Cases may be highly complex without feeling difficult for experienced clinicians, or difficult despite limited complexity.
• Educational frameworks that distinguish both concepts may improve communication, simulation design, and crisis preparedness.

Practice Applications

• Recognize difficulty and complexity as related but distinct clinical constructs.
• Consider using consistent terminology during airway assessment and team communication.
• Interpret airway risk through both operator and systems-based perspectives.
• Monitor training programs for opportunities to explicitly teach both dimensions.