IntroductionA difficult airway is one of the main causes of morbidity and mortality in patients who undergo surgical interventions. Therefore, many devices and algorithms have been developed for the management of a difficult airway. However no study has been conducted comparing Frova catheter (FC) and a Bonfils fiberoscope (BF) to date.AimTo compare the effectiveness and success of two devices, a FC and BF, in difficult intubation cases.Material and methodsDesign: Single-centre randomized controlled trial in patients with difficult airways. The assignment order was created by unplanned number charts, and the assignment was hidden in closed covers, which were not unlocked until case permission had been provided. Setting: The trial was undertaken in a university hospital in Turkey. The primary analysis was based on 60 participants (n = 30, n = 30) with difficult intubation. The main outcomes were the success rates of placement of the tracheal tube in the trachea and the duration of the tracheal intubation process.ResultsIn the BF group, successful intubation was carried out in 25 of the 30 (83.3%) patients, whereas intubation was successful in 28 of the 30 patients (93.3%) in the FC group. Patients who could not be intubated with the first device were intubated with the other device. The mean duration of intubation was 109 (85–140) s in the BF group, whereas it was 38.8 (26–60) s in the FC group.ConclusionsBoth devices were successful in difficult intubation cases. However, given the shorter duration of intubation using the FC and its lower cost as compared with that of the BF, the FC can be considered superior to the BF in difficult intubation cases.

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Purpose: This study aimed to detect tongue edema which may develop due to the long-term application of pressure of the endotracheal intubation (ETI) tube on the tongue using submental ultrasonography (USG). Also, we aimed to investigate the relationship between tongue edema with oxygen saturation values (SpO2) two h after extubation. Methods: A total of 100 patients aged 18–65 years, who underwent ETI and were followed up on mechanical ventilation were included. Patients (n = 57) who were followed up on mechanical ventilation for four days or longer after ETI were included in the study group. Those who were followed up on mechanical ventilation for three days or less after ETI were included in the control group (n = 43). The tongue cross-sectional areas (TSAs) of patients in both groups were measured twice with submental USG. The first measurement (TSA1) was performed on the 0th day of ETI in all patients in both groups. The second measurement (TSA2) was performed on the 4th day of ETI in the study group and just before extubation in the control group. The difference between TSA2 and TSA1 was defined as tongue edema. Results: The tongue edema was more prevalent in the study group (p = 0.000). The SpO2 values two h after extubation were lower in patients with tongue edema than those without tongue edema (p = 0.000). Conclusions: Tongue edema may develop due to the long-term application of pressure of the ETI tube on the tongue and may impair oxygenation after extubation. ClinicalTrials.gov Identifier: NCT05249738

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