Glidescope Anatomy

The GlideScope Video Laryngoscope provides a remarkable view of the larynx using a video camera positioned on a curved laryngoscope blade that has an exaggerated bend angle when compared to a standard Macintosh blade.

The resultant view is from the hypopharynx, at the base of tongue, above the epiglottis, looking anteriorly, up toward the larynx. This perspective gives the GlideScope the ability to visualize the larynx in a “difficult airway” where standard direct laryngoscopy view might be very poor. This perspective also explains why in most patients the larynx will appear on the GlideScope screen toward the top of the image. The original GlideScope used a red and blue LED light with a black and white video camera. All GlideScope devices now come with color cameras.

The GlideScope is one of only a few alternative intubation techniques that has become widely employed for emergency airway management and rapid sequence intubation. The insertion of a rigid curved blade functioning as a tongue retractor is similar to standard direct laryngoscopy, even though there is no direct view down the blade. The operator has to work entirely off of the video screen, for both target visualization and endotracheal intubation. This is analogous to the difference between an open laparotomy–where abdominal structures are directly exposed–and laparascopic surgery–where viewing of structures and the procedure takes place exclusively on screen. For some users the hand-eye coordination required for looking at the screen while maneuvering the left hand holding the blade, and the right hand holding a styletted tracheal tube, is a bit awkward. With minimal practice it is not very difficult.

In addition to having a camera perspective in the hypopharynx, at the base of tongue, above the epiglottis, the camera enlarges the structures and provides a wide visual field.

In the above black and white images notice the tip of the GlideScope blade at the very top of the screen, above the epiglottis, in the vallecula.

The epiglottis (brightly lit, at top of images) juts forward, covering inner laryngeal structures

The curvilinear structure on right side of bottom image is the pharyngo-epiglottic fold (PEF).

The true vocal cord (right side) in upper image is marked with asterisks (**).

The aryepiglottic fold in bottom image is marked with plus signs (++).

This is a color image from the portable version of the GlideScope, the Ranger (provided by Dr. Irene Osborn). The curvilinear structure angling from the top right side is the pharyngo-epiglottic fold. Just below this, lateral to the right arytenoid cartilages and the aryepiglottic fold, is a small recess, the pyriform sinus. The true vocal cords, farthest and deepest within the larynx, have a distinct white color.

CLICK HERE for more information on using the GlideScope

Dr. D. John Doyle’s Glidescope Users Network Web site