title: Videolaryngoscopy in the management of the difficult airway: a comparison with the Macintosh blade.
abstract: OBJECTIVE
  Several studies have shown that videolaryngoscopes can provide better laryngeal exposure than conventional laryngoscopy. These studies, however, did not exclusively focus on patients with an anticipated difficult intubation. The aim of the present study was to assess whether a videolaryngoscope would provide better laryngeal exposure than conventional laryngoscopy and therefore facilitate intubation in cases of difficult laryngoscopy.
  
  
  METHODS
  One hundred and twelve patients with an estimated difficult intubation, scheduled to undergo surgical operations, requiring general anaesthesia and endotracheal intubation, were included in the study. Direct laryngoscopy with a Macintosh blade was performed, followed by videolaryngoscopy and intubation attempt(s). The laryngeal views obtained by each method were recorded according to the Cormack/Lehane scale.
  
  
  RESULTS
  The percentage of Cormack-Lehane I and II views obtained by conventional laryngoscopy rose from 63.4 to 90.2% (P < 0.0005) with videolaryngoscopy, whereas Cormack-Lehane III and IV views declined from 36.6 to 9.8% (P < 0.0005). Intubation was successful in 98.2% of the cases.
  
  
  CONCLUSIONS
  In patients with an anticipated difficult airway, videolaryngoscopy significantly improved the laryngeal exposure thus facilitating endotracheal intubation.
authors.affiliation: Department of Anaesthesiology, 'Metaxa' Cancer Hospital of Piraeus, Greece. arkaskostas@yahoo.gr
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Stroumpoulis
authors.forename: Alexandra
authors.initials: A
authors.lastname: Pagoulatou
authors.forename: Magda
authors.initials: M
authors.lastname: Violari
authors.forename: Irini
authors.initials: I
authors.lastname: Ikonomou
authors.forename: Nausika
authors.initials: N
authors.lastname: Kalantzi
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Kastrinaki
authors.forename: Theodoros
authors.initials: T
authors.lastname: Xanthos
authors.forename: Christina
authors.initials: C
authors.lastname: Michaloliakou
mesh_terms: D005260:Female; D006801:Humans; D007440:Intubation; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012137:Respiratory System / Q000503:physiopathology*; D020535:Video-Assisted Surgery / Q000379:methods*