Balloon laryngoscopy reduces head extension and blade leverage in patients with potential cervical spine injury

Background:
Head extension and excessive laryngoscope blade levering motion
(LBLM) are undesirable during airway management of trauma patients. We
hypothesized that laryngoscopy with a modified blade facilitating glottic
exposure by balloon inflation would reduce head extension and LBLM.

      Patients and methods:
      Seventeen elective surgery patients were enrolled. Patients lay
            supine with their heads flat on a rigid board and had a rigid collar around
            their necks. Laryngoscopy was performed with the modified blade and a standard
            curved blade. Head extension and LBLM angles were determined upon maximal
            glottic exposure and compared used paired t-tests. Laryngoscopic view
            grade and oxygen saturation were also determined.


      Results:
      Balloon laryngoscopy resulted in less head extension and LBLM
            (P <0.001). Laryngoscopic view was approximately identical with
            both blades, and oxygen saturation was always above 97%.


      Conclusions:
      Balloon laryngoscopy reduces head extension and LBLM under
            simulated cervical spine precautions.