A difficult orotracheal intubation can occur when there is less than adequate exposure of the glottis by direct laryngoscopy.
Visibility on Direct Laryngoscopy
Grade
glottis fully exposed, including anterior and posterior commissures
1
glottis partially exposed, with failure to visualize the anterior commissure
2
glottis not exposed, with only corniculate cartilages visualized; only the tip of the epiglottis visible
3
no glottis structures visualized, including corniculate cartilages
4
Exposure
1 or 2
adequate
3 or 4
inadequate
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Specialty: Anesthesiology, Surgery, general, Pulmonology, Cardiology, Emergency Medicine, Otolaryngology