Difficult IntubationLeHeR-DLNCT07902986
Sniffing Position vs Left Head Rotation (LeHeR) Maneuver for Glottic View During Direct Laryngoscopy
An observational study of Difficult Intubation and Laryngoscopy, run by Sakarya University.
Trial summary
The left head rotation (LeHeR) maneuver, in which the head of the supine patient is rotated 45° to the left, is a simple, equipment-free technique proposed to improve laryngeal view during laryngoscopy. Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Difficult Intubation, Laryngoscopy, Airway Management
- What is being tested?
- Direct laryngoscopy in the sniffing position and Left Head Rotation (LeHeR) maneuver
- Type of treatment
- Surgery or procedure
- How many people
- 150 participants
- Where
- No sites listed yet
- Study dates
- 1 Dec 2026to 1 Dec 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Adult patients aged 18-70 years with ASA physical status I-III who are scheduled for elective surgery under general anesthesia with oral endotracheal intubation in the operating rooms of Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital (Cekmekoy State Hospital campus), Istanbul, Turkiye. Consecutive eligible patients will be screened, and those with a modified Cormack-Lehane grade 2A-4 view on direct laryngoscopy in the sniffing position will be included in the study.
Who may be able to join
- Age 18-70 years
- Scheduled for elective surgery under general anesthesia with oral endotracheal intubation
- ASA physical status I-III
- Modified Cormack-Lehane grade 2-4 on direct laryngoscopy in the sniffing position
- Written informed consent
Who cannot join
- Limited mouth opening (<3 fingerbreadths)
- Limited neck mobility, suspected cervical instability, or prior cervical surgery
- High aspiration risk (full stomach, gastroesophageal reflux, hiatal hernia, pregnancy)
- Neck/oropharyngeal mass, facial trauma, or pathology distorting anterior neck anatomy
- Emergency surgery
- Cormack-Lehane grade 1 view in the sniffing position
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Comparison of Glottic View Between the Sniffing Position and the Left Head Rotation (LeHeR) Maneuver During Direct Laryngoscopy: A Prospective, Observational, Self-Controlled Study
The left head rotation (LeHeR) maneuver, in which the head of the supine patient is rotated 45° to the left, is a simple, equipment-free technique proposed to improve laryngeal view during laryngoscopy. Published results are conflicting: self-controlled studies report improvement, whereas parallel-group and large cohort studies do not. This prospective, observational, self-controlled study aims to compare the glottic view obtained in the standard sniffing position with that obtained in the 45° LeHeR position in the same adult patients undergoing elective surgery under general anesthesia with direct laryngoscopy. Glottic view will be graded with the modified Cormack-Lehane classification and the Percentage of Glottic Opening (POGO) score. Intubation difficulty, need for additional maneuvers or adjuncts, hemodynamic changes, and airway trauma will also be recorded.
Read the detailed description
This single-center, prospective, observational, self-controlled study will be conducted in the operating rooms of the Çekmeköy State Hospital campus of Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital in accordance with the Declaration of Helsinki. Written informed consent will be obtained from all participants. No randomization, blinding, investigational drug, or device is involved; all anesthetic care follows institutional routine, in which the LeHeR maneuver is already used for patients with Cormack-Lehane grade 2-4 views.
Before induction, demographic data and airway assessment parameters (Mallampati score, retrognathia, thyromental distance, neck circumference, mouth opening, dentition, upper lip bite test, neck mobility) will be recorded. After induction and adequate neuromuscular blockade (3 minutes), direct laryngoscopy will be performed with an appropriately sized Macintosh blade in the sniffing position, and the best glottic view will be graded using the modified Cormack-Lehane (CL) scale and the POGO score. Patients with a CL grade 1 view will not be included in further analysis. In patients with CL grade 2A-4, the laryngoscope will be withdrawn, the head rotated 45° to the left while supine (LeHeR), and laryngoscopy repeated with CL and POGO grading. Intubation will be attempted in the LeHeR position; if unsuccessful, standard rescue maneuvers (BURP, external laryngeal manipulation, return to the sniffing position) and adjuncts (bougie/stylet) will be used and recorded.
CL grades will be compared with the Wilcoxon signed-rank test and categorical distributions with McNemar's test; POGO scores will be compared with the paired t-test or Wilcoxon signed-rank test as appropriate (p<0.05). A sample of 119 patients provides ≥90% power to detect an effect size of Cohen's d ≥0.3 (two-sided α=0.05); allowing for 25% attrition, 150 patients will be enrolled.
- Conditions
- Difficult Intubation, Laryngoscopy, Airway Management
- Being tested
- Direct laryngoscopy in the sniffing position, Left Head Rotation (LeHeR) maneuver
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Direct laryngoscopy in the sniffing positionProcedure or surgery
After induction of general anesthesia and adequate neuromuscular blockade (3 minutes), direct laryngoscopy is performed with an appropriately sized Macintosh blade with the patient's head in the standard sniffing position. The best glottic view is graded using the modified Cormack-Lehane classification and the Percentage of Glottic Opening (POGO) score. Patients with a Cormack-Lehane grade 1 view are not studied further
Left Head Rotation (LeHeR) maneuverProcedure or surgery
In patients with a Cormack-Lehane grade 2A-4 view in the sniffing position, the laryngoscope is withdrawn, the patient's head is rotated 45° to the left while supine, and direct laryngoscopy is repeated with the same Macintosh blade. The glottic view is graded again using the modified Cormack-Lehane classification and the POGO score, and endotracheal intubation is attempted in this position. If unsuccessful, standard rescue maneuvers (BURP, external laryngeal manipulation, return to the sniffing position) and adjuncts (bougie/stylet) are used per routine practice.
| Study group | Role | What they receive |
|---|---|---|
| Sniffing Position Followed by LeHeR Maneuver | Adult patients (18-70 years, ASA I-III) undergoing elective surgery under general anesthesia with direct laryngoscopy, in whom the initial glottic view in the sniffing position is modified Cormack-Lehane grade 2A-4. Each patient undergoes laryngoscopy first in the sniffing position and then with 45° left head rotation (LeHeR), serving as their own control. Receives: Procedure: Direct laryngoscopy in the sniffing position; Procedure: Left Head Rotation (LeHeR) maneuver |
What is being measured
The primary outcome is the main question the study is designed to answer.
Modified Cormack-Lehane Grade in the Sniffing Position Versus the LeHeR Position
Glottic view obtained during direct laryngoscopy with a Macintosh blade, graded using the modified Cormack-Lehane classification (1, 2A, 2B, 3A, 3B, 4; higher grades indicate a worse view). Each patient is assessed first in the sniffing position and then after 45° left head rotation (LeHeR), and the paired grades are compared within the same patient.
Measured: During direct laryngoscopy, approximately 3-10 minutes after induction of general anesthesia
Percentage of Glottic Opening (POGO) Score in the Sniffing Position Versus the LeHeR Position
Percentage (0-100%) of the glottic opening visible from the anterior commissure to the interarytenoid notch during direct laryngoscopy; higher values indicate a better view. Each patient is assessed first in the sniffing position and then after 45° left head rotation (LeHeR), and the paired scores are compared within the same patient.
Measured: During direct laryngoscopy, approximately 3-10 minutes after induction of general anesthesia
Secondary outcomes (9)
Intubation Difficulty Scale (IDS) Score
IDS score calculated as the sum of seven parameters (N1-N7): number of additional attempts, number of additional operators, number of alternative techniques, Cormack-Lehane grade minus 1 in the position in which intubation is achieved, increased lifting force (0/1), need for external laryngeal pressure (0/1), and vocal cord position (abducted 0 / adducted 1). Score 0 = easy intubation, 1-5 = slight difficulty, >5 = moderate to major difficulty.
Measured: During endotracheal intubation, from first laryngoscopy until confirmed tracheal intubation
Ease of Intubation
Ease of intubation categorized as: easy (successful at first attempt without additional maneuvers), moderate (successful at first attempt with additional maneuvers such as external laryngeal manipulation or stylet/bougie, or at second attempt), difficult (more than two attempts, a different operator or a different technique required, but ultimately successful), or impossible (fiberoptic/awake intubation required or failed intubation).
Measured: During endotracheal intubation, from first laryngoscopy until confirmed tracheal intubation
Number of Participants Requiring Additional Airway Maneuvers
Number of participants requiring BURP (backward-upward-rightward pressure), external laryngeal manipulation, or return of the head to the sniffing position to achieve intubation after the LeHeR maneuver.
Measured: During endotracheal intubation, from first laryngoscopy until confirmed tracheal intubation
Number of Participants Requiring a Bougie or Stylet
Number of participants in whom a gum elastic bougie or stylet is required to achieve endotracheal intubation.
Measured: During endotracheal intubation, from first laryngoscopy until confirmed tracheal intubation
Intubation Time
Time in seconds from passage of the laryngoscope blade between the lips to the appearance of the first end-tidal carbon dioxide waveform on capnography.
Measured: During endotracheal intubation, from first laryngoscopy until confirmed tracheal intubation
Number of Participants With Airway Trauma
Number of participants with signs of airway trauma, defined as blood on the laryngoscope blade or endotracheal tube, or lip, dental or oropharyngeal mucosal injury.
Measured: From first laryngoscopy until 5 minutes after intubation
Heart Rate
Heart rate (beats/min) recorded at predefined time points to assess hemodynamic and oxygenation changes associated with laryngoscopy and intubation.
Measured: Baseline (before induction), after induction, and at 1, 3, 5 and 10 minutes after intubation
Mean Arterial Pressure
Mean arterial pressure (mmHg) recorded at predefined time points to assess hemodynamic and oxygenation changes associated with laryngoscopy and intubation.
Measured: Baseline (before induction), after induction, and at 1, 3, 5 and 10 minutes after intubation
Peripheral Oxygen Saturation
Peripheral oxygen saturation (SpO2, %) recorded at predefined time points to assess hemodynamic and oxygenation changes associated with laryngoscopy and intubation.
Measured: Baseline (before induction), after induction, and at 1, 3, 5 and 10 minutes after intubation
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Oct 2026
- Study start1 Dec 2026 (estimated)
- Primary completion1 Aug 2027 (estimated)
- Study completion1 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Difficult IntubationStudies of the same condition, open and under way.
- More trials run by Sakarya UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 150 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Sakarya University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, halil kızılışık, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07902986
- Sponsor's protocol ID
- SEAH-EK-2026-528
- Acronym
- LeHeR-DL
- Status last verified
- Oct 2026
- First submitted
- 22 Oct 2026
- Last updated
- 29 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
1. Yezid, N. H., Poh, K., Md Noor, J., & Arshad, A. (2019). LeHeR, a simple novel approach for difficult airway in non-trauma patients. BMJ case reports, 12(8), e230201. https://doi.org/10.1136/bcr-2019-230201 2. Ono, T., Otsuka, R., Kuroda, T., Honda, E., & Sasaki, T. (2000). Effects of head and body position on two- and three-dimensional configurations of the upper airway. Journal of dental research, 79(11), 1879-1884. https://doi.org/10.1177/00220345000790111101 3. Chan, D. P., Jularbal Iii, G. C. R. M., & Mapili, I. J. R. (2023). Left Head Rotation as an Alternative to Difficult Tracheal Intubation: Randomized Open Label Clinical Trial. Interactive journal of medical research, 12, e42500. https://doi.org/10.2196/42500 4. Arul, L., Rajan, S., Sai Sandhya, V. K., Madhu, M., Manikandan, M. S., & Sreekumar, G. (2025). Impact of left head rotation (LeHeR) maneuver on glottic view during direct laryngoscopy: An observational study. Journal of anaesthesiology, clinical pharmacology, 41(4), 686-691. https://doi.org/10.4103/joacp.joacp_613_24 5. Rajan, S., Mathew, J., Sreekumar, G., Arul, L., Amin, K. N., & Paul, J. (2025). Effect of "LeHeR maneuver"on glottic view as assessed with POGO score during video laryngoscopy. Journal of anaesthesiology, clinical pharmacology, 41(3), 486-490. https://doi.org/10.4103/joacp.joacp_263_24 6. Prasad, A., & Rajan, S. (2026). Precision in Planning: Airway Battles in Pediatric Temporomandibular Joint Ankylosis. Annals of African medicine, 10.4103/aam.aam_214_26. Advance online publication. https://doi.org/10.4103/aam.aam_214_26 7. Conrad, D., Kubulus, D., Fuchs, H., Volk, T., & Berwanger, U. (2026). Left head rotation manoeuvre to improve laryngoscopic view in elective surgery: A prospective cohort study. European journal of anaesthesiology, 43(8), 665-671. https://doi.org/10.1097/EJA.0000000000002343 8. Rajan, S., Sreekumar, G., Arul, L., & Roy, R. A. (2024). Rescue LeHeR manoeuvre during difficult video laryngoscopy to aid endotrachea
Study at a glance
From the registry record, last updated by the sponsor on 29 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Glottic View Between the Sniffing Position and the Left Head Rotation (LeHeR) Maneuver During Direct Laryngoscopy: A Prospective, Observational, Self-Controlled Study
- ClinicalTrials.gov ID
- NCT07902986
- Acronym / sponsor ID
- LeHeR-DL / SEAH-EK-2026-528
- Conditions
- Difficult Intubation, Laryngoscopy, Airway Management
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 150 participants (estimated)
- Lead sponsor
- Sakarya UniversityUniversity, hospital or other
- Study start
- 1 Dec 2026 (estimated)
- Primary completion
- 1 Aug 2027 (estimated)
- Study completion
- 1 Dec 2027 (estimated)
- First posted
- 29 Oct 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The left head rotation (LeHeR) maneuver, in which the head of the supine patient is rotated 45° to the left, is a simple, equipment-free technique proposed to improve laryngeal view during laryngoscopy. Published results are conflicting: self-controlled studies report improvement, whereas parallel-group and large cohort studies do not. This prospective, observational, self-controlled study aims to compare the glottic view obtained in the standard sniffing position with that obtained in the 45° LeHeR position in the same adult patients undergoing elective surgery under general anesthesia with direct laryngoscopy. Glottic view will be graded with the modified Cormack-Lehane classification and the Percentage of Glottic Opening (POGO) score. Intubation difficulty, need for additional maneuvers or adjuncts, hemodynamic changes, and airway trauma will also be recorded.
Detailed description
This single-center, prospective, observational, self-controlled study will be conducted in the operating rooms of the Çekmeköy State Hospital campus of Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital in accordance with the Declaration of Helsinki. Written informed consent will be obtained from all participants. No randomization, blinding, investigational drug, or device is involved; all anesthetic care follows institutional routine, in which the LeHeR maneuver is already used for patients with Cormack-Lehane grade 2-4 views.
Before induction, demographic data and airway assessment parameters (Mallampati score, retrognathia, thyromental distance, neck circumference, mouth opening, dentition, upper lip bite test, neck mobility) will be recorded. After induction and adequate neuromuscular blockade (3 minutes), direct laryngoscopy will be performed with an appropriately sized Macintosh blade in the sniffing position, and the best glottic view will be graded using the modified Cormack-Lehane (CL) scale and the POGO score. Patients with a CL grade 1 view will not be included in further analysis. In patients with CL grade 2A-4, the laryngoscope will be withdrawn, the head rotated 45° to the left while supine (LeHeR), and laryngoscopy repeated with CL and POGO grading. Intubation will be attempted in the LeHeR position; if unsuccessful, standard rescue maneuvers (BURP, external laryngeal manipulation, return to the sniffing position) and adjuncts (bougie/stylet) will be used and recorded.
CL grades will be compared with the Wilcoxon signed-rank test and categorical distributions with McNemar's test; POGO scores will be compared with the paired t-test or Wilcoxon signed-rank test as appropriate (p<0.05). A sample of 119 patients provides ≥90% power to detect an effect size of Cohen's d ≥0.3 (two-sided α=0.05); allowing for 25% attrition, 150 patients will be enrolled.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Sniffing Position Followed by LeHeR Maneuver | – | Procedure: Direct laryngoscopy in the sniffing position, Procedure: Left Head Rotation (LeHeR) maneuverAdult patients (18-70 years, ASA I-III) undergoing elective surgery under general anesthesia with direct laryngoscopy, in whom the initial glottic view in the sniffing position is modified Cormack-Lehane grade 2A-4. Each patient undergoes laryngoscopy first in the sniffing position and then with 45° left head rotation (LeHeR), serving as their own control. |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Adult patients aged 18-70 years with ASA physical status I-III who are scheduled for elective surgery under general anesthesia with oral endotracheal intubation in the operating rooms of Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital (Cekmekoy State Hospital campus), Istanbul, Turkiye. Consecutive eligible patients will be screened, and those with a modified Cormack-Lehane grade 2A-4 view on direct laryngoscopy in the sniffing position will be included in the study.
Key inclusion criteria (5 listed)
- Age 18-70 years
- Scheduled for elective surgery under general anesthesia with oral endotracheal intubation
- ASA physical status I-III
- Modified Cormack-Lehane grade 2-4 on direct laryngoscopy in the sniffing position
- Written informed consent
Key exclusion criteria (6 listed)
- Limited mouth opening (<3 fingerbreadths)
- Limited neck mobility, suspected cervical instability, or prior cervical surgery
- High aspiration risk (full stomach, gastroesophageal reflux, hiatal hernia, pregnancy)
- Neck/oropharyngeal mass, facial trauma, or pathology distorting anterior neck anatomy
- Emergency surgery
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Direct laryngoscopy in the sniffing positionAfter induction of general anesthesia and adequate neuromuscular blockade (3 minutes), direct laryngoscopy is performed with an appropriately sized Macintosh blade with the patient's head in the standard sniffing position. The best glottic view is graded using the modified Cormack-Lehane classification and the Percentage of Glottic Opening (POGO) score. Patients with a Cormack-Lehane grade 1 view are not studied further | Procedure or surgery | Sniffing Position Followed by LeHeR Maneuver |
| Left Head Rotation (LeHeR) maneuverIn patients with a Cormack-Lehane grade 2A-4 view in the sniffing position, the laryngoscope is withdrawn, the patient's head is rotated 45° to the left while supine, and direct laryngoscopy is repeated with the same Macintosh blade. The glottic view is graded again using the modified Cormack-Lehane classification and the POGO score, and endotracheal intubation is attempted in this position. If unsuccessful, standard rescue maneuvers (BURP, external laryngeal manipulation, return to the sniffing position) and adjuncts (bougie/stylet) are used per routine practice. | Procedure or surgery | Sniffing Position Followed by LeHeR Maneuver |
Primary outcome
Modified Cormack-Lehane Grade in the Sniffing Position Versus the LeHeR Position
Time frame: During direct laryngoscopy, approximately 3-10 minutes after induction of general anesthesia
Glottic view obtained during direct laryngoscopy with a Macintosh blade, graded using the modified Cormack-Lehane classification (1, 2A, 2B, 3A, 3B, 4; higher grades indicate a worse view). Each patient is assessed first in the sniffing position and then after 45° left head rotation (LeHeR), and the paired grades are compared within the same patient.
Percentage of Glottic Opening (POGO) Score in the Sniffing Position Versus the LeHeR Position
Time frame: During direct laryngoscopy, approximately 3-10 minutes after induction of general anesthesia
Percentage (0-100%) of the glottic opening visible from the anterior commissure to the interarytenoid notch during direct laryngoscopy; higher values indicate a better view. Each patient is assessed first in the sniffing position and then after 45° left head rotation (LeHeR), and the paired scores are compared within the same patient.
9 secondary outcomes
Intubation Difficulty Scale (IDS) Score
Time frame: During endotracheal intubation, from first laryngoscopy until confirmed tracheal intubation
Ease of Intubation
Time frame: During endotracheal intubation, from first laryngoscopy until confirmed tracheal intubation
Number of Participants Requiring Additional Airway Maneuvers
Time frame: During endotracheal intubation, from first laryngoscopy until confirmed tracheal intubation
Number of Participants Requiring a Bougie or Stylet
Time frame: During endotracheal intubation, from first laryngoscopy until confirmed tracheal intubation
Intubation Time
Time frame: During endotracheal intubation, from first laryngoscopy until confirmed tracheal intubation
Number of Participants With Airway Trauma
Time frame: From first laryngoscopy until 5 minutes after intubation
Heart Rate
Time frame: Baseline (before induction), after induction, and at 1, 3, 5 and 10 minutes after intubation
Mean Arterial Pressure
Time frame: Baseline (before induction), after induction, and at 1, 3, 5 and 10 minutes after intubation
Peripheral Oxygen Saturation
Time frame: Baseline (before induction), after induction, and at 1, 3, 5 and 10 minutes after intubation
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Oct 2026.
- Results publication1. Yezid, N. H., Poh, K., Md Noor, J., & Arshad, A. (2019). LeHeR, a simple novel approach for difficult airway in non-trauma patients. BMJ case reports, 12(8), e230201. https://doi.org/10.1136/bcr-2019-230201 2. Ono, T., Otsuka, R., Kuroda, T., Honda, E., & Sasaki, T. (2000). Effects of head and body position on two- and three-dimensional configurations of the upper airway. Journal of dental research, 79(11), 1879-1884. https://doi.org/10.1177/00220345000790111101 3. Chan, D. P., Jularbal Iii, G. C. R. M., & Mapili, I. J. R. (2023). Left Head Rotation as an Alternative to Difficult Tracheal Intubation: Randomized Open Label Clinical Trial. Interactive journal of medical research, 12, e42500. https://doi.org/10.2196/42500 4. Arul, L., Rajan, S., Sai Sandhya, V. K., Madhu, M., Manikandan, M. S., & Sreekumar, G. (2025). Impact of left head rotation (LeHeR) maneuver on glottic view during direct laryngoscopy: An observational study. Journal of anaesthesiology, clinical pharmacology, 41(4), 686-691. https://doi.org/10.4103/joacp.joacp_613_24 5. Rajan, S., Mathew, J., Sreekumar, G., Arul, L., Amin, K. N., & Paul, J. (2025). Effect of "LeHeR maneuver"on glottic view as assessed with POGO score during video laryngoscopy. Journal of anaesthesiology, clinical pharmacology, 41(3), 486-490. https://doi.org/10.4103/joacp.joacp_263_24 6. Prasad, A., & Rajan, S. (2026). Precision in Planning: Airway Battles in Pediatric Temporomandibular Joint Ankylosis. Annals of African medicine, 10.4103/aam.aam_214_26. Advance online publication. https://doi.org/10.4103/aam.aam_214_26 7. Conrad, D., Kubulus, D., Fuchs, H., Volk, T., & Berwanger, U. (2026). Left head rotation manoeuvre to improve laryngoscopic view in elective surgery: A prospective cohort study. European journal of anaesthesiology, 43(8), 665-671. https://doi.org/10.1097/EJA.0000000000002343 8. Rajan, S., Sreekumar, G., Arul, L., & Roy, R. A. (2024). Rescue LeHeR manoeuvre during difficult video laryngoscopy to aid endotrachea
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
An observational study of Difficult Intubation and Laryngoscopy, run by Sakarya University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 29 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Halil Kızılışık, MD (+90 537 260 11 01, halilkizilisik07@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Modified Cormack-Lehane Grade in the Sniffing Position Versus the LeHeR Position (time frame: During direct laryngoscopy, approximately 3-10 minutes after induction of general anesthesia). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07902986, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Oct 2026.