direct laryngoscopy

Direct laryngoscopy lets your doctor see deeper into your throat.

Besides the conventional laryngoscopes, many other devices have been developed as alternatives to direct laryngoscopy.

Though these devices can be effective alternatives to direct laryngoscopy, they each have certain limitations, and none of them is effective under all circumstances.

The Cormack-Lehane system classifies views obtained by direct laryngoscopy based on the structures seen.

Personnel experienced in direct laryngoscopy are not always immediately available in certain settings that require emergency tracheal intubation.

In the prehospital emergency setting, digital intubation may be necessitated if the patient is in a position that makes direct laryngoscopy impossible.

Direct laryngoscopy was performed and the posterior third of the larynx visualised, and suxamethonium was given to facilitate intubation.

Kirstein performed the first direct laryngoscopy in Berlin, using an esophagoscope he had modified for this purpose; he called this device an autoscope.

Janeway was thus instrumental in popularizing the widespread use of direct laryngoscopy and tracheal intubation in the practice of anesthesiology.

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.

Also at that time, advances in endoscopic instrumentation had improved to such a degree that direct laryngoscopy had become a viable means to secure the airway by the non-surgical orotracheal route.

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.

The superior performance of video laryngoscopes in airway management where cervical spine injury is possible has raised the question of whether these scopes should supersede direct laryngoscopy in routine airway management.

Other devices such as rigid stylets, the lightwand (a blind technique) and indirect fiberoptic rigid stylets, such as the Bullard scope, Upsher scope and the WuScope can also be used as alternatives to direct laryngoscopy.

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.

The frequent failure of direct laryngoscopy to provide an adequate view for tracheal intubation led to the development of alternative devices such as the lighted stylet, and a number of indirect fiberoptic viewing laryngoscopes, such as the fiberscope, Bullard scope, Upsher scope, and the WuScope.