Issues with Current Oral Airways


After examination and on comparison, current Guedel and Berman airways are dimensionally very different in relation to the proportional measurements and it is easy to see that these inconsistencies do not correspond to any design and anatomical logic. Since these two devices were developed to open and maintain the oropharynx airway, shouldn’t they have the same dimensions? The answer is a resounding, “Yes”.

 

Further our studies showed that these common oral airways possess no proportional dimensional standards in relation to the length change in the bite block and the radius of the C curve. This impacts the radius of the back body portion and how it will control and impact the anatomical structures of the oropharynx, i.e., tongue, epiglottis, etc. These dimensional inconsistencies greatly impact how either airway design functions in relation to the anatomical requirements to keep an airway open.

 

It should also be noted that without the jaw-thrust design element and the ability to control the tongue, the relaxed jaw will allow for the relaxed tongue to fall back into the oropharynx because there is nothing to support it, resulting in an airway obstruction, causing complications for the anesthetist and the patient.

 

Comparison of using current Berman oral airway (left) versus our LJT oral airway and the alignment angle of the maxillary and mandibular teeth and jaw under anesthesia. Notice that the LJT airway protracts the lower mandibular jaw and pulls the tongue and genioglossus muscle forwards and prevents the tongue from moving back on the epiglottis and oropharynx, thus holding it away from the posterior pharyngeal wall.