The direct view into the glottis can be difficult due to long teeth in the upper jaw or abnormities of the neck vertebrae. It is recommended in these cases to use either a mediastinoscope with a lateral slot or the McIntosh laryngoscope, which is commonly used for intubation. The latter can be attached to the chest stay of the normal laryngoscope by using a special joint. The tip of the McIntosh laryngoscope is inserted into the valleculae instead of loading up the epiglottis as is done with the normal laryngoscope. Recommended aids for ciopsy or polypectomy are the 30 degrees-optical system of bronchoscopy or the gastroscope, each with its forceps.