laryngoscoop

A laryngoscoop, or laryngoscope, is a medical instrument used to visualize the larynx and aid tracheal intubation. It consists of a blade attached to a handle that provides illumination and helps lift the tongue and epiglottis to expose the glottis. Blades are curved (Macintosh) or straight (Miller); some devices include a video camera or fibre-optic bundle for indirect visualization.

Direct laryngoscopy relies on a direct line of sight to the larynx, achieved by aligning the mouth, throat, and larynx. The blade illuminates the airway and guides endotracheal tube placement. Video laryngoscopes add a camera and external display, which can improve glottic visualization, especially in difficult airways.

Indications include securing the airway during anesthesia, rapid sequence intubation in emergencies, and airway assessment in critically ill patients. Practitioners such as anesthesiologists, emergency physicians, and otolaryngologists choose blade type and technique based on anatomy and clinical needs.

Technique basics involve inserting the blade from the right side of the mouth, sweeping the tongue to the left, and lifting the epiglottis to reveal the vocal cords before advancing the tube. Verify tube placement with visualization, auscultation, or capnography.

Safety concerns include dental injury, soft tissue trauma, sore throat, and rare airway damage. Complications relate to hypoxia, aspiration, or hemodynamic changes during intubation. Proper training, equipment maintenance, and monitoring are essential; video laryngoscopy may reduce difficulty but requires familiarity with the device.

Historically, direct laryngoscopy emerged in the 19th and early 20th centuries, with curved Macintosh and straight Miller blades becoming standard in the mid-20th century. Video laryngoscopy gained widespread use in the late 20th and early 21st centuries, expanding airway management options.