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We appreciate the comments by Liu et al (1) regarding our review of indirect videolaryngoscopy (2). We appreciate their thoughts on this rapidly emerging and developing area of airway management. They propose a different opinion as to how these devices should be classified. Although we respect their opinions as obvious experts in the field, we believe that the classification of such devices remains a matter of semantics and may require further deliberation and development. We continue to hold to our suggestion that the primary classification should be channeled versus nonchanneled with a secondary division along the types of blades that are available. If one uses the classification that they suggest (Macintosh, tube channel, angulated, and Miller), I am not sure how one would classify the C-MAC videolaryngoscope as it has blades of the Macintosh, Miller, and a sharper or angulated version (Storz C-MAC D-blade). Perhaps, instead of using the primary division as “channeled” or “nonchanneled Macintosh type,” we would have been more correct to say “channeled” versus “nonchanneled” with a secondary division along the type of blades that are available (standard anesthesia type vs nonstandard). As any one of the videolaryngoscopes may have different types of blades, we do not believe that the blade type should be a primary decision point but a secondary or tertiary point. Subclassification of blades could then occur as Macintosh, Miller, or hyperangulated.
We appreciate the correction regarding the manufacturer of the McGrath MAC videolaryngoscope. We were not clear in distinguishing between manufacturer/developer and the company that markets the device. As with most medical equipment, the marketing company may vary based on the country in question. In the United States, we believe that Covidien (Medtronic) markets this videolaryngoscope as it is displayed on their website. We apologize for the confusion that we caused. We appreciate the clarification of the types of blades available for the Pentax Airway Scope. Our review stated that “various blades are available including standard, thin, pediatric, and neonatal” although we may not have provided enough detail for clinical use.
We appreciate your providing to us the updated and corrected information regarding the UEScope. Our review of their website on April 7, 2017 ( revealed blade choices, which include five sizes of reusable blades (Miller 0 and Macintosh 1, 2, 3, and 4) and three reusable blades (Macintosh 2, 3, and 4). Liu et al (1) obviously have significant clinical experience with this device, although its use in the United States has been limited. We can only offer the possibility that there are variations in the types of blades available in various countries.
As demonstrated by this letter and the available literature, there remains significant variability based on the specific country and the clinicians involved regarding the popularity and clinical experience with individual devices. Although the Glidescope was the first introduced into common clinical practice in the United States and remains the device that has been studied most in clinical trials, numerous other videolaryngoscopes have been introduced for clinical use (3). The recent report from the pediatric difficult airway registry confirms the use of the Glidescope in 80% of cases (4).
We appreciate the thoughtful comments by Liu et al (1) regarding our review article. Any discussion regarding these devices only serves to improve education and patient care. In our busy clinical world, I appreciate the time and effort Liu et al (1) have taken to respond to our review article.

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