{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:26:23Z","timestamp":1780579583278,"version":"3.54.1"},"reference-count":26,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: In this study, it was shown that the routine use of McGrath videolaryngoscopy may improve intubation success rates. The benefits to using a videolaryngoscope in nasotracheal intubation were also demonstrated. However, no solid evidence concerning the effectiveness of the use of McGrath videolaryngoscopes in nasotracheal intubation has previously been reported. As a result, we questioned whether, in adult patients who underwent oral and maxillofacial surgeries with nasotracheal intubation (P), the use of a McGrath videolaryngoscope (I) compared with a Macintosh laryngoscope (C) could reduce the intubation time, improve glottis visualization to a score of classification 1 in the Cormack\u2013Lehane classification system, and improve the first-attempt success rate (O). The secondary outcomes measured were the rate of the use of Magill forceps and the external laryngeal pressure (BURP) maneuver used. Methods: An extensive literature search was conducted using databases. Only randomized controlled trials that compared the McGrath videolaryngoscopy and Macintosh laryngoscopy techniques in nasotracheal intubation in adult patients were included. Results: Five articles met the inclusion criteria and were included in the final analysis (n = 331 patients). The results showed a significant decrease in intubation time and a higher rate of classification 1 scores in the Cormack\u2013Lehane classification system, but no difference in the first-attempt success rates were found between the McGrath group and the Macintosh group. Decreases in the rate of the use of Magill forceps and the use of the external laryngeal pressure maneuver were also found in the pooled analysis. With regard to the overall risk of bias, the selected trials were classified to have at least a moderate risk of bias, because none of the trials could blind the operator to the type of laryngoscope used. Conclusions: Our analysis suggests that the use of a McGrath videolaryngoscope in nasotracheal intubation resulted in shorter intubation times, improved views of the glottis and similar first-success rates in adult patients who received general anesthesia for dental, oral, maxillofacial, or head and neck cancer surgery, and also reduced the use of Magill forceps and the BURP maneuver.<\/jats:p>","DOI":"10.3390\/jcm11092499","type":"journal-article","created":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T05:44:07Z","timestamp":1651297447000},"page":"2499","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A Comparison of McGrath Videolaryngoscope versus Macintosh Laryngoscope for Nasotracheal Intubation: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"given":"Chia-Hao","family":"Ho","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Far Eastern Memorial Hospital, Banqiao Dist., New Taipei City 220, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Chung","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Far Eastern Memorial Hospital, Banqiao Dist., New Taipei City 220, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Hao","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Far Eastern Memorial Hospital, Banqiao Dist., New Taipei City 220, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu-Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Far Eastern Memorial Hospital, Banqiao Dist., New Taipei City 220, Taiwan"},{"name":"Department of Mechanical Engineering, Yuan Ze University, Taoyuan 320, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chang Gung University College of Medicine, Chiayi Chang Gung Memorial Hospital, Puzi City, Chiayi 613, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2217-3231","authenticated-orcid":false,"given":"Cheng-Wei","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Far Eastern Memorial Hospital, Banqiao Dist., New Taipei City 220, Taiwan"},{"name":"Department of Mechanical Engineering, Yuan Ze University, Taoyuan 320, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e016907","DOI":"10.1136\/bmjopen-2017-016907","article-title":"Evaluation of the McGrath MAC and Macintosh laryngoscope for tracheal intubation in 2000 patients undergoing general anaesthesia: The randomised multicentre EMMA trial study protocol","volume":"7","author":"Kriege","year":"2017","journal-title":"BMJ Open"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.jclinane.2017.12.030","article-title":"McGrath videolaryngoscope versus Macintosh laryngoscope for tracheal intubation: A systematic review and meta-analysis with trial sequential analysis","volume":"46","author":"Hoshijima","year":"2018","journal-title":"J. Clin. Anesth."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1007\/s12663-013-0516-5","article-title":"Nasotracheal Intubation: An Overview","volume":"13","author":"Prasanna","year":"2014","journal-title":"J. Maxillofac. Oral Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.jclinane.2018.08.029","article-title":"Videolaryngoscopy versus direct laryngoscopy for nasotracheal intubation: A systematic review and meta-analysis of randomised controlled trials","volume":"52","author":"Jiang","year":"2019","journal-title":"J. Clin. Anesth."},{"key":"ref_5","first-page":"D142","article-title":"Updated guidance for trusted systematic reviews: A new edition of the Cochrane Handbook for Systematic Reviews of Interventions","volume":"10","author":"Cumpston","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_6","first-page":"105906","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE guidelines: 1. Introduction\u2014GRADE evidence profiles and summary of findings tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J. Clin. Epidemiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12871-019-0838-z","article-title":"A randomized controlled comparison of non-channeled king vision, McGrath MAC video laryngoscope and Macintosh direct laryngoscope for nasotracheal intubation in patients with predicted difficult intubations","volume":"19","author":"Zhu","year":"2019","journal-title":"BMC Anesthesiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"17365","DOI":"10.1038\/s41598-018-35857-8","article-title":"A comparison of the Macintosh laryngoscope, McGrath video laryngoscope, and Pentax Airway Scope in paediatric nasotracheal intubation","volume":"8","author":"Yoo","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12871-020-01021-x","article-title":"Comparison of C-MAC D-blade videolaryngoscope and McCoy laryngoscope efficacy for nasotracheal intubation in simulated cervical spinal injury: A prospective randomized comparative study","volume":"20","author":"Seo","year":"2020","journal-title":"BMC Anesthesiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"381","DOI":"10.4103\/joacp.JOACP_296_17","article-title":"Ease of intubation and hemodynamic responses to nasotracheal intubation using C-MAC videolaryngoscope with D blade: A comparison with use of traditional Macintosh laryngoscope","volume":"34","author":"Kadapamannil","year":"2018","journal-title":"J. Anaesthesiol. Clin. Pharmacol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1097\/00029330-200807020-00009","article-title":"Circulatory responses to nasotracheal intubation: Comparison of GlideScope\u00ae videolaryngoscope and Macintosh direct laryngoscope","volume":"121","author":"Xue","year":"2008","journal-title":"Chin. Med. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"35","DOI":"10.4103\/sja.SJA_239_17","article-title":"A randomized controlled trial comparing C Mac D Blade and Macintosh laryngoscope for nasotracheal intubation in patients undergoing surgeries for head and neck cancer","volume":"12","author":"Hazarika","year":"2018","journal-title":"Saudi J. Anaesth."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1213\/ane.0b013e31816d15c9","article-title":"A Comparison of GlideScope\u00ae Videolaryngoscopy to Direct Laryngoscopy for Nasotracheal Intubation","volume":"107","author":"Jones","year":"2008","journal-title":"Anesth. Analg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.joms.2015.07.021","article-title":"McGrath Video Laryngoscopy Facilitates Routine Nasotracheal Intubation in Patients Undergoing Oral and Maxillofacial Surgery: A Comparison With Macintosh Laryngoscopy","volume":"74","author":"Kwak","year":"2016","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Sato, A., Sobue, K., Kako, E., Tachi, N., Okumura, Y., Kanazawa, M., Hashimoto, M., Harada, J., and Boku, A.S. (2017). The usefulness of the McGrath MAC laryngoscope in comparison with Airwayscope and Macintosh laryngoscope during routine nasotracheal intubation: A randomaized controlled trial. BMC Anesthesiol., 17.","DOI":"10.1186\/s12871-017-0451-y"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.2147\/TCRM.S220451","article-title":"A comparison of McGrath MAC, Pentax AWS, and Macintosh direct laryngoscopes for nasotracheal intubation: A randomized controlled trial","volume":"15","author":"Chae","year":"2019","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1007\/s12630-019-01409-5","article-title":"Randomized comparison of McGrath MAC videolaryngoscope, Pentax Airway Scope, and Macintosh direct laryngoscope for nasotracheal intubation in patients with manual in-line stabilization","volume":"66","author":"Roh","year":"2019","journal-title":"Can. J. Anaesth."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"477","DOI":"10.4103\/joacp.JOACP_1_20","article-title":"A randomized controlled trial comparing McGRATH series 5 videolaryngoscope with the Macintosh laryngoscope for nasotracheal intubation","volume":"36","author":"Ambulkar","year":"2020","journal-title":"J. Anaesthesiol. Clin. Pharmacol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1093\/bja\/aew058","article-title":"Evaluation of six videolaryngoscopes in 720 patients with a simulated difficult airway: A multicentre randomized controlled trial","volume":"116","author":"Greif","year":"2016","journal-title":"Br. J. Anaesth."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1111\/j.1365-2044.2008.05653.x","article-title":"Comparison of the Glidescope\u00ae, the McGrath\u00ae, the Airtraq\u00ae and the Macintosh laryngoscopes in simulated difficult airways*","volume":"63","author":"Savoldelli","year":"2008","journal-title":"Anaesthesia"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1093\/bja\/aep384","article-title":"Difficult tracheal intubation","volume":"104","author":"Combes","year":"2010","journal-title":"Br. J. Anaesth."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"193","DOI":"10.2344\/anpr-67-02-08","article-title":"Comparing Video and Direct Laryngoscopy for Nasotracheal Intubation","volume":"67","author":"King","year":"2020","journal-title":"Anesth. Prog."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1007\/s12630-017-0971-4","article-title":"Randomized comparison of the effectiveness of nasal intubation using a GlideScope video laryngoscope with Magill forceps versus vascular forceps in patients with a normal airway","volume":"64","author":"Yeom","year":"2017","journal-title":"Can. J. Anaesth."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13063-021-05677-9","article-title":"Comparison of a tube core and Magill forceps for nasotracheal intubation: A randomised controlled trial","volume":"22","author":"Hu","year":"2021","journal-title":"Trials"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"72","DOI":"10.5603\/AIT.a2019.0002","article-title":"Complications associated with nasotracheal intubation and proposal of simple countermeasure","volume":"51","author":"Yamamoto","year":"2019","journal-title":"Anaesthesiol. Intensive Ther."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/9\/2499\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:04:12Z","timestamp":1760137452000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/9\/2499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,29]]},"references-count":26,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["jcm11092499"],"URL":"https:\/\/doi.org\/10.3390\/jcm11092499","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,29]]}}}