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Anatomical parts seen during laryngoscopy. Direct laryngoscopy is carried out (usually) with the patient lying on their back; the laryngoscope is inserted into the mouth on the right side and flipped to the left to trap and move the tongue out of the line of sight, and, depending on the type of blade used, inserted either anterior or posterior to the epiglottis and then lifted with an upwards ...
The Cormack–Lehane system classifies views obtained by direct laryngoscopy based on the structures seen. It was initially described by R.S. Cormack and J. Lehane in 1984 as a way of simulating potential scenarios that trainee anaesthetists might face.
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Laryngoscope: used in direct laryngoscopy; video link: Jobson Horne's probe with ring curette: to access or clean the external ear: Tuning forks: for various clinical tests of hearing loss; vibration sense test Pritchard's politzerization apparatus: video link: Aural/Ear syringe: used to flush out anything like ear wax or foreign bodies from ...
Limitations of video laryngoscopy exist and prevent the exclusive use of this method over direct laryngoscopy. Excessive blood and saliva in the airway can cover the camera lens on the video laryngoscope and obscure effective visualization of the anatomy, preventing effective intubation attempts.
In 1913, Chevalier Jackson was the first to report a high rate of success for the use of direct laryngoscopy as a means to intubate the trachea. [121] Jackson introduced a new laryngoscope blade that incorporated a component that the operator could slide out to allow room for passage of an endotracheal tube or bronchoscope. [122]
A systematic review of 42 studies, with 34,513 participants, found that the modified Mallampati score is a good predictor of difficult direct laryngoscopy and intubation, but poor at predicting difficult bag mask ventilation.
It is clinically important in performing direct laryngoscopy with a Macintosh laryngoscope blade; the blade tip is placed in the vallecula and moved anteriorly, which causes the hyoepiglottic ligament to pull the epiglottis anteriorly as well and thus expose the glottis. [citation needed]