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.