Abstract
We investigated the efficacy of the McGrath videolaryngoscope compared with the Macintosh laryngoscope in children with torticollis. Thirty children aged 1–10 years who underwent surgical release of torticollis were randomly assigned into the McGrath and Macintosh groups. Orotracheal intubation was performed by a skilled anesthesiologist. The primary outcome was the intubation time. The Cormack–Lehane grade, lifting force, intubation difficulty scale (IDS), difficulty level, and intubation failure rate were also assessed. The intubation time was significantly longer in the McGrath group than in the Macintosh group (31.4 ± 6.7 s vs. 26.1 ± 5.4 s, p = 0.025). Additionally, the Cormack–Lehane grades were comparable between the groups (p = 0.101). The lifting force and IDS were significantly lower in the McGrath group than in the Macintosh group (p < 0.001 and p = 0.022, respectively). No significant differences were observed with respect to endotracheal intubation difficulty and intubation success rate. Intubation-related complications were also not observed. In conclusion, compared with the Macintosh laryngoscope, the McGrath videolaryngoscope extended the intubation time and did not improve glottic visualization in children with torticollis, despite having a lesser lifting force, lower intubation difficulty scale, and similar success rate.
Highlights
Congenital muscular torticollis is a common musculoskeletal anomaly with an incidence of up to 16% of healthy newborns [1]. It is characterized by ipsilateral cervical lateral flexion and contralateral cervical rotation caused by unilateral contracture of the sternocleidomastoid muscle [2]
This study aimed to assess the efficacy of the McGrath VL compared with the Macintosh laryngoscope in children with torticollis who require endotracheal intubation for general anesthesia
Children aged 1–10 years with an American Society of Anesthesiologists physical status 1 or 2, who were diagnosed with congenital muscular torticollis and underwent an elective surgical release of torticollis under general anesthesia with orotracheal intubation, were included
Summary
Congenital muscular torticollis is a common musculoskeletal anomaly with an incidence of up to 16% of healthy newborns [1]. It is characterized by ipsilateral cervical lateral flexion and contralateral cervical rotation caused by unilateral contracture of the sternocleidomastoid muscle [2]. Up to 90% of infants with congenital muscular torticollis have craniofacial asymmetry as a coexisting impairment [3]. The degree of facial asymmetry or plagiocephaly may progress and result in the development of secondary changes, such as cervical spine dysmorphism and limited neck mobility [4,5,6,7]
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