AUTHOR=Castillo-Monzón Caridad G. , Marroquín-Valz Hugo Antonio , Gaszynski Tomasz , Cayuela Manuel , Orozco Javier , Ratajczyk Pawel 

TITLE=How does head position affect laryngeal vision with a video laryngeal mask airway?

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1469225

DOI=10.3389/fmed.2024.1469225

ISSN=2296-858X

ABSTRACT=The laryngeal mask airway Vision Mask (LMA VM) is a supraglottic airway device with a vision guidance system. The ideal head and neck position for direct laryngoscopy is known, but the ideal position for placing a LMA is not. The objective of this study is to evaluate and compare the optimal position for placement of a video laryngeal mask airway.Methods: This was a prospective, observational, transversal and analytical study of 72 consecutive patients. In the same patient, laryngeal vision was first assessed with the head and neck in the sniffing position and then with the head in the neutral position.Procedures were performed by the same investigator. Assessment of the laryngeal view was performed using two classifications: Cormack-Lehane classification and Brimacombe classification. Device placement was considered adequate when the Cormack-Lehane rating was scored from 1 to 2 and the Brimacombe rating was from 2 to 4.This study was done on 72 patients. In the assessment of the glottis using the Cormack Lehane classification for fiberoptic view, laryngeal visibility was adequate in 64 (88.89%) patients in the neutral position and in 65 (90,28%) patients in the sniffing position (p>0,05). In the fiberoptic view of the glottis, evaluated using the Brimacombe classification, laryngeal visibility was adequate in 68 (93%) patients in the neutral position and in 69 (95%) patients in the sniffing position, (p>0,05). There was no statistically significant difference in the rate of success between the sniffing position (70 patients, 97.22% success rate) and the neutral position (67 patients, 93.06% success rate) during the first insertion attempt. Two patients required a second attempt in the sniffing position, while five patients required a second attempt in the neutral position.An adequate sniffing position did not result in a better glottic view than the neutral position. Additional maneuvers were equal in both positions. The head-neck position does not influence on the placement of a third generation SAD.