Positioning

To obtain a direct line of sight, the patient is positioned in the "sniffing position." The neck is flexed at the lower cervical spine and extended at the atlanto-occipital joint. This flexion and extension is amplified during laryngoscopy.

The patient’s neck mobility should be assessed preoperatively by having them flex and extend their head maximally. The range of motion should be more than 90°. Motion less than 80° may triple the risk of a poor view at laryngoscopy.