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

Abstract

ObjectiveThis study aimed to evaluate whether GlideScope® is an effective and acceptable method for the removal of a hypopharyngeal foreign body. MethodsThis 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. ResultsThe 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 46s, IQR 28–75s) forceps than Sponge forceps (median 79s, IQR 41–88s). ConclusionsIn 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.