“Hanger” in Intubation and Laryngoscopy

  • Devkumar Rengaraja
  • Mohan Jagade
  • Radhika Sonate
  • Karthik Rao
  • Deoshri Ramtek
Original Article


Achieving an adequate exposure in laryngoscopy is an extremely tedious task for the operating surgeon, especially for the anterior commissure lesions. Various maneuvers have been described to overcome this difficulty, but failed in providing an adequate exposure leading to a poor outcome. To create a device that can deliver uniform pressure over the laryngeal cartilage and succeed in providing an adequate exposure of the glottic lesion. A total of 44 patients were included in the study, divided into two groups containing 22 patients each. The distance at the level of anterior commissure from the superior border of the distal end of the laryngoscope was noted and compared. Group A subjected to digital cricoid pressure showed a mean distance of 9.09 of exposure with variance of 1.22 and Group B subjected to cricoid pressure with the cricoid catapult showed a mean distance of 11.76 with variance of 1.59. The groups were statistically analyzed using Anova Test and the test was found to be very significant (p < 0.0001). The catapult is made of a hanger defining its economics, which has a vital role in difficult intubations especially in anterior placed larynx, short neck and obese patients, also succeeds in providing an adequate exposure of the glottic lesion, (especially the anterior commissure) by delivering uniform pressure over the laryngeal cartilage, leading to a superior operative outcome.


Catapult Cricoid pressure Anterior commissure Intubation 



I acknowledge the support of our head of the departments of ENT and Head & Neck Surgery and Anesthesia. I also acknowledge the support of nursing and technical staff who were involved in the process of surgery, postoperative care and other works. I also acknowledge all the patients who gave us consent and supported us for this. I acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. I am also grateful to the authors/editors/publishers of all those articles and journals from where the literature for this article has been reviewed and discussed. There were no special support sources/or grants used. There were no conflicts of interest.

Compliance with Ethical Standards

Conflict of interest

There is no conflict of interest.


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Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  1. 1.Grant Medical College and Sir JJ Group of HospitalsMumbaiIndia

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