Dear Editor,
Routinely during tonsillectomy a Boyle Davis mouth gag with tongue blade is applied to open the oral cavity and to keep the tongue away from the operative field. While the mouth gag is of a standard universal size the tongue blade has to be changed for an adult or child depending upon the size of the oral cavity. Since all tongue blades fitted on the mouth gag have similar dimensions for the handle and only the tongue plate varies in size depending on adult or paediatric patient a modified tongue blade having separate detachable handle and tongue plates has been designed and successfully tried at our hospital.
The tongue blade consists of two parts :
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(a)
A universal handle six inches in length, which is hooked at one end to fit onto Draffins bipods and has a socket at the proximal end with a tempered side screw for fitting the tongue plate. The outer surface of the handle is grooved on which the Boyle Davis mouth gag can slide.
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(b)
Tongue plates of different sizes from paediatric to adult.
These plates have a small projection at the distal end which fits into the socket at the proximal end of the universal handle and is kept in place by tightening the screw on the handle. The screw is tempered inside the socket to prevent it from getting dislodged and becoming a foreign body (Fig. 1, Fig. 2).
Fig. 1.
Universal longue blade
Fig. 2.
Universal tongue blade
The assembled tongue blade though it offers no technical advantage over the routinely used tongue blades, if makes more economic sense since it has only one universal handle with different tongue plates, thus obviating the requirement of having multiple tongue blades for different age groups.