hyperangulated

Hyperangulated refers to a laryngoscope blade and intubation approach that uses a more acute curvature than traditional blades. The design aims to improve visualization of the glottis during airway management, especially in difficult airways, by providing an indirect view through a video camera rather than a direct line of sight.

Hyperangulated blades are commonly used with video laryngoscope systems. They have a pronounced distal bend that directs the glottic opening toward the camera at the blade tip, facilitating visualization without aligning the oral, pharyngeal, and laryngeal axes. Because the blade curvature is steep, clinicians typically shape the endotracheal tube with a rigid stylet to match the blade’s geometry and guide the tube toward the glottic opening.

Clinical use and considerations: Hyperangulated blades are favored in anticipated difficult airways, restricted mouth opening, or limited neck mobility, where direct laryngoscopy may be challenging. They can improve first-pass visualization and may reduce intubation attempts in certain settings, but outcomes strongly depend on operator experience and patient anatomy. The technique often requires different hand-eye coordination and a different tube advancement approach compared with conventional blades.

Limitations and challenges: The pronounced curvature can make tube advancement through the vocal cords more difficult if the stylet and tube are not properly prepared, and there is a potential for dental or soft tissue trauma if not used carefully. Adequate training with the specific blade and associated video laryngoscope system is important to minimize complications.