title: Balloon laryngoscopy reduces head extension and blade leverage in patients with potential cervical spine injury.
abstract: BACKGROUND
  Head extension and excessive laryngoscope blade levering motion (LBLM) are undesirable during airway management of trauma patients. We hypothesized that laryngoscopy with a modified blade facilitating glottic exposure by balloon inflation would reduce head extension and LBLM.
  
  
  METHODS
  Seventeen elective surgery patients were enrolled. Patients lay supine with their heads flat on a rigid board and had a rigid collar around their necks. Laryngoscopy was performed with the modified blade and a standard curved blade. Head extension and LBLM angles were determined upon maximal glottic exposure and compared used paired t-tests. Laryngoscopic view grade and oxygen saturation were also determined.
  
  
  RESULTS
  Balloon laryngoscopy resulted in less head extension and LBLM (P <0.001). Laryngoscopic view was approximately identical with both blades, and oxygen saturation was always above 97%.
  
  
  CONCLUSIONS
  Balloon laryngoscopy reduces head extension and LBLM under simulated cervical spine precautions.
authors.affiliation: Department of Anesthesiology, Evangelismos General Hospital, Athens, Greece.
authors.forename: S D
authors.initials: SD
authors.lastname: Mentzelopoulos
authors.forename: M V
authors.initials: MV
authors.lastname: Tsitsika
authors.forename: M P
authors.initials: MP
authors.lastname: Balanika
authors.forename: M J
authors.initials: MJ
authors.lastname: Joufi
authors.forename: E A
authors.initials: EA
authors.lastname: Karamichali
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries*; D017558:Elective Surgical Procedures; D004867:Equipment Design; D006257:Head; D006801:Humans; D015601:Injury Severity Score; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D011300:Preoperative Care; D016059:Range of Motion, Articular; D012680:Sensitivity and Specificity; D013124:Spinal Injuries / Q000175:diagnosis* / Q000601:surgery