Abstract
Objective
Proper head and neck positioning is an important factor for successful direct laryngoscopy,
and the optimum position in edentulous patients is unclear. We compared direct laryngoscopic
views in simple head extension, sniffing, and elevated sniffing positions in edentulous
patients.
Methods
Eighteen adult edentulous patients scheduled for elective surgery were included in
the study. After induction of anesthesia, the laryngeal view was assessed under direct
laryngoscopy using the percentage of glottic opening (POGO) score in 3 different head
and neck positions in a randomized order: simple head extension without a pillow,
sniffing position with a pillow of 7 cm, and elevated sniffing position with a pillow
of 10 cm. After assessment of the laryngeal views, tracheal intubation was performed.
Results
A significant difference was observed in the laryngeal views assessed at the 3 head
positions (P= .001). The POGO scores (mean [SD]) in the sniffing position (78.9% [19.7%]) and
elevated sniffing position (72.6% [20.8%]) were significantly improved compared to
that with simple head extension (53.8% [25.9%]) (P= .001, respectively). The sniffing position provided the best laryngeal view. The
mean POGO scores were higher in the sniffing position than the elevated sniffing position,
but no significant difference was observed between these 2 positions (P= .268).
Conclusions
The sniffing and elevated sniffing positions provide better laryngeal views during
direct laryngoscopy compared to simple head extension in edentulous patients.
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Article Info
Publication History
Published online: June 07, 2016
Accepted:
June 2,
2016
Received:
April 6,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
