McGrath Video Laryngoscope (MVL) - A video-based system for tracheal intubation that utilizes a video camera embedded into a "camera stick". A disposable transparent sterile blade covers the camera stick, which can be easily adjusted in position using a simple ratchet mechanism. The resulting video image is displayed on a small color Liquid Crystal Display (LCD) attached to the top of the handle of the device, which can be adjusted to obtain the best view. The unit is powered with a single easily-replaced AA battery and features a single electronic control: an on/off switch located on the top of the unit. The device is available with an adjustable curved MAC blade (sizes 3 to 5). Also, the device features a sterile disposable transparent blade sheath preventing cross infection. The unit is used in much the same manner as the conventional laryngoscope with the exception that once it has been introduced into the mouth by a few centimeters, attention should be directed to the LCD display. There is usually no need for any lifting force. It is easy to use, even in some patients who are ordinarily difficult to intubate because of an "anterior larynx". This ease of use is based on the fact that direct line of sight need not be established to get a good view of the glottis when the MVL is employed. As the image is transferred to the LCD display, anesthesiologists are able to view key anatomical landmarks at the earliest possible time, facilitating navigation. Also, in cases requiring external laryngeal manipulation, the assistant can see the effect of the maneuver on the monitor simultaneously with the anesthesiologist for quicker, more efficient intubation. GlideScope Video Laryngoscope (GVL)- The GlideScope was commercially introduced in 2001. The 1- piece handle and blade is made of medical- grade plastic. It has a vertical profile of 14.5 mm, a midblade bend of 50-60 degrees, and a video camera with a light-emitting diode housed toward the distal end of the blade. The image captured by the camera is transferred by the attached cable to a color liquid crystal display (LCD). A heating element covers the camera lens and ensures effective antifogging after the device has been turned on for 15- 30 seconds. The blades can be sterilized and reused, and are available in 3 sizes: large (adult), midsize (pediatric), and small (neonatal). More recent versions of the GlideScope include the Ranger, which is a Compact, battery- based portable unit; and the Cobalt, which features a reusable internal video baton for placement within large (adult) or small (pediatric) disposable blades. Use of a GlideScope requires a styletted tube to facilitate tracheal tube passage, either a regular (e. g., Satin-Slip) stylet or the dedicated GlideScope rigid stylet, preformed to conform to the shape of the scope blade; both are equally effective.18 As the image is transferred to the LCD display, anesthesiologists are able to view key anatomical landmarks at the earliest possible time, facilitating navigation. Also, in cases requiring external laryngeal manipulation, the assistant can see the effect of the maneuver on the monitor simultaneously with the anesthesiologist for quicker, more efficient intubation. Endotrol Tracheal Tube (ETT) (Covidien, Colorado, USA) - A sterile, single lumen, disposable ET with a built- in flexing mechanism with a standard 15 mm connector. The tube provides directional tip control via an operator- activated ring loop and incorporates a self- sealing valve with attached pilot balloon. The ETT is specifically designed for use in cases where difficult intubation can be aided with directional tip control. Due to the Hi-Lo cuff design, the ETT is acceptable for oral/nasal intubation of the trachea for anesthesia and in cases where the intubation duration is expected to be more than 24 hours or unpredictable. The special way to hold the ETT is to place the thumb of the right hand against the end of the 15 mm connector and the index finger in the ring loop. Pulling on the ring loop causes the tip to turn anteriorly towards the tracheal opening. Several reports have been published describing trauma to the upper airway (anterior tonsillar pillar, soft palate) during video laryngoscopes guided intubation using styletted tracheal tube.9-14 We believe that Endotrol tacheal tube (Covidien, Colorado, USA) may be a safer alternative to the styletted tracheal tube in regards to the upper airway injury.