Purpose of review: To summarize the current state of the art in upper-airway evaluation, focusing on endoscopic techniques, and especially to make a comparison between rigid and flexible instrumentation.
Recent findings: 'Noninvasive' techniques such as computed tomography or magnetic resonance imaging (especially cine-magnetic resonance imaging) can yield useful information, but endoscopy remains the gold standard. There is increasing understanding of the limitations and special advantages of rigid and flexible techniques for airway endoscopy; neither yields the entire picture in every patient.
Summary: The combination of both rigid and flexible endoscopic techniques, together with a carefully orchestrated approach to sedation/anesthesia, will yield the most accurate, complete, and useful information.