[A modified Macintosh blade with an angulated tip for difficult intubations]

The depth of the proximal part of a normal Macintosh blade was carved more shallow and the tip of the blade was made adjustable in its angle by means of a joint controlled by a screw-lock fixation via a small wire parallel to the blade. Clinical experience with this modified blade in 33 patients is reported. In 10 of 13 patients with severely reduced mouth opening less than or equal to 25 mm and 19 of 20 patients with a mouth opening greater than 25 mm, visibility during laryngoscopy with the modified blade was improved, compared to the normal Macintosh blade. The carved proximal part of the blade improves its maneuverability in a small mouth avoiding undue pressure on the incisors, the adjustable tip increases the blade's pressure on the base of the tongue lifting the epiglottis.