Difficult laryngoscopy made easy with the use of left-hand laryngoscope blade.
In scenarios where difficult airway is anticipated as a result of a mass or any pathology in the right side of the upper airway, the plan of approach depends on the extent of difficulty assessed by various airway assessment tests/methods. If significant difficulty is suspected some of the available options include either an awake/sedated fibreoptic or blind nasal intubations. When the airway pathology involves part of the right side or exclusively the whole of the right side compressing the airway towards the left, there is no room to position a normal right or straight blade. A left-hand laryngoscope can be used in these types of cases where anatomy and contour of the blade manoeuvres the tongue and the right-sided lesion, thereby providing an unobstructed left-sided view of the larynx. The left-hand laryngoscope blade has been useful in converting the Cormack and Lehane grade III/IV laryngoscopies to grade II in our cases where the pathology was located exclusively on the right side of the airway. These cases suggest that there may be a role of left-hand laryngoscope in the management of difficult airway, particularly, in cases where there are right-sided mass lesions obstructing the airway.
Das Adhikary
S
S
Department of Anaesthesia, Christian Medical College, Vellore, India. sanjib@cmcvellore.ac.in
Venkatesan
T
T
Mohanty
S
S
Ponniah
M
M
D000328:Adult; D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D004867:Equipment Design; D006258:Head and Neck Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed