Communication Paradox in Shared Airway Management: A Multicenter Survey

OBJECTIVES: To assess communication practices, perceived barriers, and collaborative attitudes among anesthesiologists in shared airway scenarios, and quantify the gap between perceived value and actual utilization of interdisciplinary airway information. METHODS: Multicenter cross-sectional survey of anesthesiology residents and specialists at four Israeli tertiary medical centers (January-February 2026). Outcome measures included frequency of seeking otolaryngologic input, perceived usefulness, barriers to utilization, and attitude-behavior correlations across three scenarios: impending airway obstruction, elective direct microlaryngoscopy, and trauma-related airway management. RESULTS: Of 165 eligible anesthesiologists, 152 responded (93%). Otolaryngologic input was rated very helpful or essential by 68.4% in impending obstruction and helpful by 47.4% in trauma, yet 25.7% and 41.4% rarely or never sought it, respectively. In elective cases, 43.4% rarely or never reviewed preoperative otolaryngology flexible laryngoscopy video recordings, despite 28.9% expressing concern about iatrogenic vocal fold injury. Perceived value correlated only moderately with utilization (Spearman ρ = 0.27-0.58, all p < 0.001). Primary barriers were systemic: inconsistent otolaryngology recording, incompatible electronic systems, and time constraints. Specialists rated otolaryngologic input and training more favorably than residents (p < 0.05). Support for joint simulation-based training was near-unanimous (90.8%). CONCLUSION: Anesthesiologists consistently value otolaryngologic input but frequently fail to utilize it due to systemic rather than attitudinal barriers. Structural interventions, including EMR-integrated airway data, standardized perioperative briefings, and joint simulation training, are needed to bridge this gap.