Comparison of GlideScope(®) versus Macintosh laryngoscope for the removal of a hypopharyngeal foreign body: a randomized cross-over cadaver study

Abstract

OBJECTIVE: This study aimed to evaluate whether GlideScope(®) is an effective and acceptable method for the removal of a hypopharyngeal foreign body.

METHODS: This was a prospective study conducted in 28 first year emergency residents with little prior airway management experience. Participants extracted hypopharyngeal foreign bodies using a Macintosh laryngoscope and GlideScope(®) with Magill and Sponge forceps. The primary endpoints were extraction time and success rate with each device. Participant preferences were also assessed.

RESULTS: The cumulative success rate in relation to time to extraction was significantly higher with the Macintosh laryngoscope than with the GlideScope(®) (p<0.001) regardless of the extraction device. Significantly fewer attempts were required for the first successful extraction with the Macintosh laryngoscope versus GlideScope(®) with Magill forceps (p=<0.001) and Sponge forceps (p=<0.001). The time for successful foreign body extraction using GlideScope(®) was significantly lower when using Magill (median 46 s, IQR 28-75 s) forceps than Sponge forceps (median 79 s, IQR 41-88 s).

CONCLUSIONS: In this cadaver model, the Macintosh laryngoscope appeared to be more efficient and preferred than GlideScope(®) for extracting hypopharyngeal airway foreign bodies that are associated with fatal asphyxiation.