title: Assessment of patient position for fiberoptic intubation using videolaryngoscopy.
abstract: OBJECTIVE
  To compare laryngoscopic appearance obtained during flexible fiberoptic laryngoscopy with the patient's atlanto-occipital joint in the neutral and extended positions.
  
  
  METHODS
  Controlled clinical trial with each patient (in the neutral position) acting as his or her own control.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  20 adult ASA physical status I and II patients, without anatomical airway abnormalities, undergoing elective surgical procedures.
  
  
  METHODS
  Fiberoptic laryngoscopy was performed on each patient with his or her atlanto-occipital joint in the neutral and extended positions.
  
  
  RESULTS
  Photographs of the laryngoscopic appearances were graded on a scale of 1 to 4 by a blinded observer according to the proportion of the laryngeal inlet visible. Atlanto-occipital extension improved laryngoscopic appearance in 14 cases and produced no change in the remaining 6.
  
  
  CONCLUSIONS
  Atlanto-occipital extension is a useful maneuver during attempted fiberoptic intubation.
authors.affiliation: Department of Anesthesia, Massachusetts General Hospital, Boston 02114, USA.
authors.forename: G D
authors.initials: GD
authors.lastname: Shorten
authors.forename: H H
authors.initials: HH
authors.lastname: Ali
authors.forename: J T
authors.initials: JT
authors.lastname: Roberts
mesh_terms: D000328:Adult; D001269:Atlanto-Occipital Joint / Q000033:anatomy & histology*; D017558:Elective Surgical Procedures; D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation; D005931:Glottis / Q000033:anatomy & histology; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D007828:Laryngoscopy / Q000379:methods; D007830:Larynx / Q000033:anatomy & histology; D008297:Male; D008875:Middle Aged; D011187:Posture; D016037:Single-Blind Method; D014741:Video Recording; D014827:Vocal Cords / Q000033:anatomy & histology