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Distortion of anterior airway anatomy during laryngoscopy with the GlideScope videolaryngoscope

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Abstract

Purpose

A non-line-of-sight view is expected to cause less movement of the anterior airway anatomy and cervical spine during laryngeal visualization. Reduced distortion of anterior airway anatomy during laryngoscopy with the GlideScope videolaryngoscope (GVL), compared with the Macintosh laryngoscope, could explain the relatively easier nasotracheal intubation with the GVL. The purpose of this radiographic study was to compare the degree of anterior airway distortion and cervical spine movement during laryngoscopy with the GVL and the conventional Macintosh laryngoscope.

Methods

Twenty patients requiring general anesthesia and tracheal intubation were studied. Each patient underwent laryngoscopy using the first-generation GVL and a direct laryngoscope with a Macintosh blade. During each laryngoscopy, a radiograph was taken when the best view of the larynx was obtained. Independent radiologists with subspeciality training in musculoskeletal imaging evaluated anterior airway distortion and cervical spine movement.

Results

The distance between the epiglottis and the posterior pharyngeal wall during the GlideScope procedure was 21% less than that during the Macintosh laryngoscopy (P < 0.05). Anterior deviations of the vertebral bodies from baseline were 27, 32, 36, and 39% less at the atlas, C2, C3, and C4 vertebrae, respectively, during the GlideScope procedure than those measured during Macintosh laryngoscopy (P < 0.01). Cervical extension between the occiput and C4 during the GlideScope procedure was 23% less than that during Macintosh laryngoscopy (P < 0.05).

Conclusion

Both anterior airway distortion and cervical spine movement during laryngeal visualization were less with the GVL than with the Macintosh laryngoscope.

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Acknowledgment

The authors thank the radiology technologists at Jichi Medical University Hospital.

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Yoshihiro Hirabayashi & Norimasa Seo

  2. Department of Radiology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Akifumi Fujita & Hideharu Sugimoto

Authors
  1. Yoshihiro Hirabayashi
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  2. Akifumi Fujita
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  3. Norimasa Seo
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  4. Hideharu Sugimoto
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Corresponding author

Correspondence to Yoshihiro Hirabayashi.

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Hirabayashi, Y., Fujita, A., Seo, N. et al. Distortion of anterior airway anatomy during laryngoscopy with the GlideScope videolaryngoscope. J Anesth 24, 366–372 (2010). https://doi.org/10.1007/s00540-010-0927-0

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  • DOI: https://doi.org/10.1007/s00540-010-0927-0

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