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British Journal of Anaesthesia, 1989, Vol. 63, No. 4 435-438
© 1989 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

DISPOSITION OF CERVICAL VERTEBRAE, ATLANTO—AXIAL JOINT, HYOID AND MANDIBLE DURING X-RAY LARYNGOSCOPY

W. A. HORTON, B.D.S., M.B., CH.B., F.F.A.R.C.S., L. FAHY, B.CH., F.F.A.R.C.S., F.F.A.R.C.S.I. and P. CHARTERS, M.D., M.R.C.P., F.F.A.R.C.S., B.A.

Clatterbridge Hospital, Clatterbridge Road Bebington, Wirral L63 4JY
Royal Liverpool Hospital Prescot Street, Liverpool L7 8XP

Correspondence to P.C.

Ten healthy volunteers underwent direct laryngoscopy using topical anaesthesia and a curved Macintosh laryngoscope blade. A lateral x-ray was performed during laryngoscopy in a standard intubating position. In this position the lower neck was relatively straight and increasing curvature occurred from the mid cervical spine upwards. Extension at the atlanto—axial joint was probably near maximum; this has implications for conditions associated with laxity of this joint. The position of the mandible was influenced by the direction of pull on the laryngoscope handle. The hyoid was drawn forward and its body tilted downwards so as to lie halfway between the lower border of the mandible and the glottis. The relative length of epiglottis projecting above the hyoid was variable.


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