{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:58:38Z","timestamp":1790618318995,"version":"4.1.0"},"reference-count":21,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Inonu University Scientific Research Projects Coordination Unit","award":["5012"],"award-info":[{"award-number":["5012"]}],"id":[{"id":"https:\/\/ror.org\/04asck240","id-type":"ROR","asserted-by":"crossref"}]},{"award":["5012"],"award-info":[{"award-number":["5012"]}],"id":[{"id":"https:\/\/ror.org\/04asck240","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: This study aimed to compare glottic visualization and intubation performance during laryngoscopy with the C-MAC video laryngoscope size 1 Miller blade using direct epiglottic elevation versus vallecular placement of the blade tip in children younger than 2 years of age. Methods: This prospective, randomized controlled trial enrolled 127 ASA physical status I\u2013II children younger than 2 years undergoing elective surgery. Participants were randomly allocated to Group V (vallecular placement; n = 62) or Group E (direct epiglottic elevation; n = 65). Anesthesia was induced with fentanyl, thiopental, sevoflurane, and rocuronium. The Percentage of Glottic Opening (POGO) score, Cormack\u2013Lehane grade, Intubation Difficulty Score (IDS), Visual Analogue Scale (VAS) score, laryngoscopy and intubation times, intubation attempts, optimization maneuvers, and complications were recorded. Results: The POGO score was significantly higher in Group E (median [IQR], 96 [92\u2013100]) than in Group V (95 [88\u2013100]; p = 0.032). Cormack\u2013Lehane grades were significantly better in Group E than in Group V (p = 0.042). Laryngoscopy time was significantly shorter in Group V (5.61 \u00b1 1.15 s) than in Group E (6.95 \u00b1 1.80 s; p = 0.001). Intubation time was also significantly shorter in Group V (23.16 \u00b1 4.44 s) than in Group E (26.60 \u00b1 4.73 s; p = 0.001). VAS scores were significantly higher in Group V (9.48 \u00b1 1.09) than in Group E (9.02 \u00b1 1.09; p = 0.018). Conclusions: Direct epiglottic elevation with the C-MAC video laryngoscope size 1 Miller blade improved glottic visualization, whereas vallecular placement was associated with shorter laryngoscopy and intubation times in children younger than 2 years. The choice between the two techniques may depend on clinical priorities; vallecular placement may be considered when minimizing intubation time is a priority, although this hypothesis requires prospective evaluation in higher-risk populations.<\/jats:p>","DOI":"10.3390\/jcm15197483","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:50:54Z","timestamp":1790614254000},"page":"7483","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of C-MAC Miller 1 Blade Placement in the Vallecula Versus Direct Epiglottic Elevation on Glottic Visualization and Intubation Performance in Children Under 2 Years of Age: A Prospective Randomized Controlled Trial"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2415-2936","authenticated-orcid":false,"given":"Ahmet","family":"Ken\u00e7","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Battalgazi State Hospital, Malatya 44210, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9506-1871","authenticated-orcid":false,"given":"Zekine","family":"Bege\u00e7","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine, \u0130n\u00f6n\u00fc University, Malatya 44210, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00dclk\u00fc","family":"\u00d6zg\u00fcl","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine, \u0130n\u00f6n\u00fc University, Malatya 44210, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5406-098X","authenticated-orcid":false,"given":"Cemil","family":"\u00c7olak","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, and Medical Informatics, Faculty of Medicine, \u0130n\u00f6n\u00fc University, Malatya 44210, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5436-3654","authenticated-orcid":false,"given":"Oya Olcay","family":"\u00d6zde\u015f","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine, \u0130n\u00f6n\u00fc University, Malatya 44210, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1111\/pan.14244","article-title":"Comparative efficacy of C-MAC\u00ae Miller videolaryngoscope versus McGrath\u00ae MAC size 1 videolaryngoscope in neonates and infants undergoing surgical procedures under general anesthesia: A prospective randomized controlled trial","volume":"31","author":"Gupta","year":"2021","journal-title":"Pediatr. 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