The brightness of the glow that should be seen in a particular patient can be gauged before intubation by shining the light through the patient's cheeks. Identification of the typical pre-tracheal glow is the most crucial part of the lighted stylet intubation . Obtaining the correct glow may require quite a few number of repositionings and may not be achieved on the first attempt. Troubleshooting Tips Cannot find pre-tracheal glow. Not enough space to maneuver.
Lighted stylet is stuck in a piriform fossae or in the vallecula.
Patient too obese - cannot see glow. Stylet may be stuck in the vallecula, giving impression of a pre-tracheal glow. The ETT is getting stuck on the vocal cords. Move non-dominant hand from the mandible to the lighted stylet handle and advance the ETT which is still being held with the dominant hand to the desired depth. While advancing the ETT, the pre-tracheal glow can often be observed to travel with the ETT tip down the neck, as the ETT acts as a light pipe.