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Abstract Confirmed difficulties with previous airway management or a preoperative airway examination can assist anesthesiologists in a risk assessment of potential difficulties. Mallampati classification, head and neck mobility, mouth opening, the ability/inability of opening the jaw, prognathism, body weight, and the thyro-mental distance. Awake fiberoptic intubation is a gold standard technique for patients with anticipated difficult tracheal intubation. Video laryngoscopy provides better laryngeal view than conventional Macintosh direct laryngoscopy.The flexible fiberoptic endoscope has for many years been the preferred instrument in such situations, but the maintenance of the necessary psychomotor skills for fiberoptic intubation can be a significant problem. Many complications such asbrain damage and death associated with anticipated difficult airway management and awake intubation.Therefore, it is imperative to search for simple, reliable, safe, and effective intubation equipment.The video laryngoscope is a new portable laryngoscope that is found useful in patients with a difficult laryngoscopy or intubation. The video laryngoscope can improve visualization of the glottic structures one to two grades using the Cormack-Lehane classification system compared with conventional laryngoscopy using a Macintosh laryngoscope. We aimed in this study to compare the efficacy of video laryngoscopy to direct flexible intubating laryngoscopy regarding successful first-attempt intubation, glottic visualization and time to intubation |