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Correspondence  |   November 2000
Patient in “Sniffing Position”
Author Notes
  • University of California San Diego Medical Center
  • San Diego, California.
  • jbenumof@ucsd.edu
Article Information
Correspondence
Correspondence   |   November 2000
Patient in “Sniffing Position”
Anesthesiology 11 2000, Vol.93, 1365-1366. doi:
Anesthesiology 11 2000, Vol.93, 1365-1366. doi:
To the Editor:—
Contrary to the statement in the letter by Adnet et al.,  1 figure 1 does not show a patient in the sniffing position. The sniffing position necessitates approximately 30–35° of flexion of the neck axis on the chest axis. Placing a patient’s head on a pillow is irrelevant if it does not achieve this end point. In figure 1 of the letter by Adnet et al.  , 1 the neck seems to be flexed on the chest by only 5°. If the neck had been flexed on the chest by approximately 30–35°, the laryngeal axis would be almost identical to the pharyngeal axis, and the laryngeal and pharyngeal axes would be much closer to the oral axis. In addition, flexion of the neck on the chest might have permitted a slightly greater degree of extension of the head axis on the neck axis, thereby further bringing the laryngeal, pharyngeal, and oral axes into alignment. I do not believe that figure 1 of the letter by Adnet et al.  1 shows the patient in sniffing position.
Reference
Reference
Adnet F, Borron SW, Lapostolle F, Lapandry C: The three axis alignment theory and the “sniffing position”: Perpetuation of an anatomic myth? A nesthesiology 1999; 91: 1964–5Adnet, F Borron, SW Lapostolle, F Lapandry, C