Inclusion Criteria:  Patients requiring general anesthesia with transoral tracheal intubation for elective surgery Age ≥ 18 Preoperative airway assessment reveals an expected difficult airway (rated by the responsible anesthetist in the Pre-assessment Clinic based on the existing in-house algorithm)  Exclusion Criteria:  Pregnant or breastfeeding woman Confirmed indications for awake fiberoptic intubation especially due to enoral, pharyngeal tumors, abscesses or other processes Planned endotracheal intubation without deep anesthesia or neuromuscular blocking agents (e.g. awake videolaryngoscopy) Required transnasal tracheal intubation (e.g. for surgical reasons) Requirement of special endotracheal tubes such as laser or RAE tubes for surgical reasons Patients at risk for pulmonary aspiration who qualify for rapid sequence induction Loose teeth Denial of consent