A new blade for blind endotracheal intubation.

In patients with various anatomical features, difficulty in performing endotracheal intubation occurs approximately once in 65 direct laryngoscopies (White and Kander, 1975). The anatomical abnormalities include a short muscular neck with a full set of teeth; a receding lower jaw with an obtuse mandibular angle, protruding upper incisors from relative overgrowth of the premaxilla, a long, high, arched palate associated with a narrow mouth and increased alveolar-mental distance (Cass, James and Lines, 1956; Wylie and Churchill-Davidson, 1972; Thornton, 1974; White and Kander, 1975). Several pathological conditions of the soft and bony tissues also may render endotracheal intubation difficult or impossible. These include cervical spondylosis, contractures of the neck and face as a result of burns, scleroderma, achondroplasia in dwarfism and radiation fibrosis of the tongue (Mather, 1966). In children, difficult endotracheal intubation is encountered frequently in patients with micrognathia, Still's disease or cleft palate (d'Arcy et al., 1976). In most of these conditions one is unable to visualize the larynx with a laryngoscope.