An Angulated Laryngoscope for Routine and Difficult Tracheal Intubation

Bellhouse, C. P.

doi:10.1097/00000542-198807000-00024

Cited by 68 publications

(37 citation statements)

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“…Another limitation is that a longer teeth flange distance has not yet been proven to decrease the incidence of dental damage. Other methods to decrease dental injury in at-risk patients include tooth protectors, 17 angulated blades, 18 blades with soft heels or with no heel at all. 6 So far, no single approach has proven to be superior with respect to the prevention of tooth damage.…”

Section: Discussionmentioning

confidence: 99%

Lower flange modification improves performance of the Macintosh, but not the Miller laryngoscope blade

Kimberger

Fischer

Plank

et al. 2006

Can J Anesth/J Can Anesth

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Purpose:In order to minimize the potential for dental damage and to improve laryngeal visualization during tracheal intubation, two commonly used laryngoscope blades were modified and compared in a clinical setting: the Miller laryngoscope blade and the Macintosh laryngoscope blade. Modified versions of both laryngoscope blades with a lowered heel (Callander modification) at the proximal end of the blade were compared to standard blades. Methods:Forty patients scheduled for general anesthesia requiring endotracheal intubation were studied prospectively. Preoperatively, the patients' airways were evaluated according to Mallampati score, thyromental distance and interincisor gap. After induction of anesthesia laryngoscopy was performed with the original laryngoscope and its modified counterpart in random order. A lateral x-ray of the neck was taken after the optimal view had been obtained, and blade-tooth distance, laryngeal view, blade-tooth contact and need for assistance were measured. Using angular calculations the laryngoscopes were analyzed at different insertion depths on graph paper, and the results were compared with data from the lateral x-rays.Results: With a modified Macintosh blade the blade-tooth distance was significantly greater in comparison to the original design (2.5 ± 2.1 cm vs 0.2 ± 0.1 cm, P < 0.01). Consequently the number of blade-tooth contacts was significantly lower (20% vs 75%, P < 0.05). The best laryngeal view could be obtained using a modified Macintosh laryngoscope. With a modified Miller laryngoscope laryngeal visibility was not improved and assistance was required more often to achieve adequate intubating conditions (35% vs 5%, P < 0.05). Conclusion:A reduction of the proximal flange of a Miller blade decreases the blade's effectiveness for laryngeal visualization, whereas a similar modification of a Macintosh blade increases blade-tooth distance, decreases the number of bladetooth contacts and provides a better laryngeal view. Objectif

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Section: Discussionmentioning

confidence: 99%

Lower flange modification improves performance of the Macintosh, but not the Miller laryngoscope blade

Kimberger

Fischer

Plank

et al. 2006

Can J Anesth/J Can Anesth

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show abstract

“…Several modifications of the commonly used laryngoscopic blades and use of tooth protectors have been described to protect and guard dental structures in cases of difficult visualization of the larynx [2,[13][14][15][16][17][18][19][20][21]. Tooth protectors may protect the tooth enamel from chipping but may also decrease the opening of the mouth, interfere with visualization of the larynx, and increase the difficulty of guiding the endotracheal tube into the larynx [2,21].…”

Section: Discussionmentioning

confidence: 99%

The usefulness of the modified laryngoscopic blade for training novice laryngoscopists

Lee¹,

Kim²,

Chang³

et al. 2005

Journal of Clinical Anesthesia

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“…Intubation difficulties and problems with airway management during emergence remain among the leading causes of serious intraoperative problems, [4] and it has been estimated that inability to manage successfully very difficult airways is responsible for as many as 30% of deaths totally attributable to anesthesia [5] [6] . Generally, failed tracheal intubation occurs once in every 2230 attempts.…”

Section: Introductionmentioning

confidence: 99%

Modified Mallampati Test, Sternomental Distance, and Thyromental Distance for Prediction of Difficult Intubation in Patients Undergoing General Anaesthesia

Aswini¹

2017

JMSCR

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An Angulated Laryngoscope for Routine and Difficult Tracheal Intubation

Cited by 68 publications

References 0 publications

Lower flange modification improves performance of the Macintosh, but not the Miller laryngoscope blade

Lower flange modification improves performance of the Macintosh, but not the Miller laryngoscope blade

The usefulness of the modified laryngoscopic blade for training novice laryngoscopists

Modified Mallampati Test, Sternomental Distance, and Thyromental Distance for Prediction of Difficult Intubation in Patients Undergoing General Anaesthesia

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