{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T18:05:00Z","timestamp":1759514700164},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T00:00:00Z","timestamp":1596412800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T00:00:00Z","timestamp":1596412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Oral Invest"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>In this study, we aimed to assess the feasibility of fiberoptic intubation (FOI), using a new, self-designed, \u201ctongue root holder\u201d device, in combination with the jaw thrust maneuver.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Three hundred patients undergoing elective surgery requiring orotracheal intubation were enrolled. Patients presented at least one or more risk factors for difficult airway. The patients were randomly allocated at a 1:1 ratio to one of two groups: group L, FOI with tongue root holder, or group C, standard FOI. Orotracheal FOI was performed after commencement of anesthesia. The jaw thrust maneuver was applied in both groups to facilitate advancement of the fiberoptic bronchoscope. The primary endpoint was the feasibility of FOI. The secondary endpoints were number of attempts, time to intubation, and airway clearance at the soft palate and epiglottis levels.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The FOI was achieved in all 150 patients in group L, significantly higher than that in group C (100% vs 95.3%; <jats:italic>P<\/jats:italic>\u2009=\u20090.015). Less attempts of intubation were made in group L (<jats:italic>P<\/jats:italic>\u2009=\u20090.039). Mean time to successful intubation on the first attempt was shorter in group L (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The mean times to view the vocal cord and carina were also shorter in group L (<jats:italic>P<\/jats:italic>\u2009=\u20090.011 and <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001, respectively). Airway clearance was better in group L at both the soft palate and the glottis levels (<jats:italic>P<\/jats:italic>\u2009=\u20090.010 and <jats:italic>P<\/jats:italic>\u2009=\u20090.038, respectively).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study shows that FOI is feasible with the newly introduced, self-designed, \u201ctongue root holder\u201d device, when combined with the jaw thrust maneuver in patients with risk factors for difficult airway. The device also provides better airway clearance, less intubation attempts, and shorter time to intubation at first attempt.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Clinical relevance<\/jats:title>\n<jats:p>Fiberoptic bronchoscope has been the gold standard for routine management of difficult airway. A technique to open the airway is introduced to reduce the incidence rate of upper airway obstruction.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00784-020-03297-2","type":"journal-article","created":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T06:04:48Z","timestamp":1596434688000},"page":"4335-4342","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A new self-designed \u201ctongue root holder\u201d device to aid fiberoptic intubation"],"prefix":"10.1007","volume":"24","author":[{"given":"Xiaofei","family":"Cao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junbei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengnian","family":"Ding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Qi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,8,3]]},"reference":[{"issue":"2","key":"3297_CR1","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1097\/ALN.0b013e31827773b2","volume":"118","author":"JL Apfelbaum","year":"2013","unstructured":"Apfelbaum JL, Hagberg CA, Caplan RA, Blitt CD, Connis RT, Nickinovich DG, Hagberg CA, Caplan RA, Benumof JL, Berry FA, Blitt CD, Bode RH, Cheney FW, Connis RT, Guidry OF, Nickinovich DG, Ovassapian A (2013) Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. 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