Letters to the Editor: Letters & Announcements
To the Editor:
The video laryngoscope is a major technological advancement in anesthesia practice (1–3) because it captures and magnifies the image of the glottis near the tip of the laryngoscope blade. Compared with conventional laryngoscopes, a video laryngoscope may provide a better view of the glottis. Several varieties of video laryngoscopes are available, but most are expensive. In contrast, the Truview laryngoscope (Truphatek, Natanya, Israel), a Macintosh-type blade with an optical lenses attached (Fig. 1), costs about the same as conventional blades. We report successfully using the Truview laryngoscope in two patients with difficult airways in whom endotracheal intubation with a Macintosh laryngoscope had failed.
Case 1. A 49-yr-old woman with a history of temporomandibular arthritis was scheduled for mastectomy. She had Mallampati class 2 airway, with a 2.5 finger-width gap between her upper and lower incisors. After anesthetic induction and neuromuscular blockade, we encountered difficulty opening her mouth. Laryngoscopy with a Macintosh blade could not reveal the glottis. In contrast, with the Truview laryngoscope, we could see the posterior part of the glottis, and successfully intubated the trachea with the aid of a gum elastic bougie.
Case 2. A 72-yr-old man, 172 cm, 56 kg, with an unremarkable airway was scheduled for gastrectomy. After anesthetic induction and neuromuscular blockade, we tried and failed at several attempts at endotracheal intubation with a Macintosh blade. The primary problem was a large, floppy epiglottis. We inserted a Truview laryngoscope, viewed the posterior part of the glottis, and inserted a tracheal tube into the trachea with the aid of a gum elastic bougie.
We have experienced several other cases in which a Macintosh blade failed to expose the glottis, but the Truview laryngoscope did. We believe that the Truview laryngoscope is a simple and inexpensive device that may be useful in patients with difficult airways.
Sanae Matsumoto, MD
Takashi Asai, MD, PhD
Koh Shingu, MD
Kansai Medical University Otokoyama Hospital
Yawata City, Kyoto, Japan
Kansai Medical University
Moriguchi City, Osaka, Japan
1. Cooper RM. Use of a new video laryngoscope (GlideScope) in the management of a difficult airway. Can J Anaesth 2003;50:611–3.
2. Asai T, Shingu K. Use of the video laryngoscope. Anaesthesia 2004;59:513.
3. Okuda Y, Inoue H, Arai T, et al. Video recording of tracheal intubation. Anaesthesia 2005;60:1042–3.