Comparison of Upper Lip Bite Test, Ratio of Height to Thyromental Distance, and Maxillopharyngeal Angle to Predict Difficult Laryngoscopy
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 5, Issue 11
Abstract
Introduction: The incidence of “difficult” intubation is approximately 1–4%, whereas the most dreadful incidence of “cannot ventilate by mask, cannot intubate” is around 0.0001–0.02%. Materials and Methods: A total of 556 patients aged between 18 and 65 years of ASA I and II scheduled for elective general anesthesia with intubation were analyzed preoperatively for upper lip bite test (ULBT), ratio of height to thyromental distance (RHTMD), and maxillopharyngeal angle (MPA). Cormack-Lehane (CL) grading was noted in them by an experienced anesthesiologist who was unaware of the pre-operative findings. Results: The incidence of difficult laryngoscopy was 12.8%. ULBT had a high positive predictive value (42.11%) and stood second in terms of sensitivity, specificity, negative predictive value (NPV), and accuracy (90.93%, 45.07%, 91.88%, and 81.07%), respectively. RHTMD had high sensitivity (71.83%) and NPV (93.49%). MPA had highest specificity and diagnostic accuracy (94.43% and 85.79%). Conclusion: Each of the three parameters significantly correlated with CL grading. However, each test scored differently in terms of their sensitivity, specificity, accuracy, and predictive tests when compared to each other. Hence, it will be safer to use a combination of tests which assess different aspects of patient’s airway.
Authors and Affiliations
Pallavi Butiyani, Tasneem Unjhawala, H K Sale, Sangeeta Chandrashekar, Geetanjali Dangat, Lisa Prakash
Keywords
Related Articles
- EP ID EP476886
- DOI -
- Views 100
- Downloads 0
Ligamentous Reconstruction for Post-traumatic Chronic Instability of Distal Radioulnar Joint
Introduction: Disorders of the distal radioulnar joint (DRUJ) are a common source of ulnar-sided wrist pain. The ulnar side of the wrist has often been likened to the lower back because of the difficulties involved in es...
Microbiological Efficacy of Meropenem–ethylenediaminetetraacetic Acid Combination as Compared to Meropenem in a Tertiary Care Intensive Care Unit
Background: With the global epidemic of sepsis on the rising trend and gram negative sepsis being one of the most common cause of increasing morbidity and mortality in developing nations like India, it becomes imperative...
Does Hypothyroidism Promote Gallstone Formation?
Introduction: Gallstone disease is a very common disorder affecting humans, particularly fertile females. Although there are numerous established risk factors in the development of gallstones, hypothyroidism is a commonl...
Pathological Spectrum of Gastrointestinal Stromal Tumors - A 1.5-year Experience at Kidwai Cancer Institute
Introduction: Gastrointestinal stromal tumors (GISTs) have an incidence of 10–15 per million per year worldwide. Majority of GISTs are located in the stomach (55.6%) followed by small bowel (31.8%). Some GISTs may be fou...
Outcome of Duhamel’s Pull-through in Hirschsprung’s Disease: A Tertiary Center Experience
Background: Duhamel’s procedure (DP) is one of the classical surgeries described for Hirschsprung’s disease (HD). It is the most common procedure for HD at our center. Objective: Analysis of the results, complications, a...