RADIOLOGICAL PREDICTORS OF DIFFICULT INTUBATION- A PROSPECTIVE STUDY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 18
Abstract
BACKGROUND Anaesthesiologists are confronted daily with the task of determining whether endotracheal intubation will be of increased difficulty in a patient. Several clinical tests were designed to predict difficult intubation. But none of the tests has provided satisfactory results in terms of sensitivity and specificity. A reasonable explanation is that the clinical tests are all physical examinations according to the surface markers, so the effect of bones may not be included. Lateral neck radiography may be regarded as an important predictor of difficult laryngoscopy. MATERIALS AND METHODS Two hundred and eight patients in the age group of 25-65 years of either sex were included in the study. We assessed the radiological variables: the atlanto-occipital distance, cervical vertebra C-2 spine depth, effective mandibular length, anterior mandibular depth, posterior mandibular depth in all the patients. Patients with tumours or malformations of head and neck and oral cavity, edentulous patients, pregnant patients and those requiring emergency surgeries were excluded. A Cormack-Lehane grade of I and II were considered as easy intubation and III and IV were considered as difficult intubation. RESULTS Thirty-eight patients had difficult intubation. The Atlanto-Occipital distance has sensitivity and specificity of 97.43% and 94.11%. The PPV and NPV is 78.72% and 99.37%. In Effective Mandibular Length, the sensitivity and specificity are 67.56% and 66.66%. The PPV and NPV is 30.48% and 90.47%. In Anterior Mandibular Depth, the sensitivity and specificity are 77.77% and 51.16%. The PPV and NPV is 25% and 91.66%. In Posterior Mandibular Depth the sensitivity and specificity are 43.24% and 52.04%. The PPV and NPV is 16.32% and 80.90%. In C2 Spine depth the sensitivity and specificity are 48.71% and 59.76%. The PPV and NPV is 21.83% and 83.47%. CONCLUSION From this study, we found that 1. Lateral neck radiography is useful but unable to provide good sensitivity in prediction of difficult intubation. 2. Only the atlanto-occipital distance variable has significant sensitivity and specificity as a single radiological predictor.
Authors and Affiliations
Sivaraj P, Padmanaban K. R
Keywords
Related Articles
- EP ID EP556391
- DOI 10.18410/jebmh/2018/306
- Views 57
- Downloads 0
INTRATHORACIC RUPTURE OF HEPATIC HYDATID CYST- A RARE COMPLICATION OF HYDATID DISEASE
PRESENTATION OF CASE Intrathoracic rupture with resultant pleurobiliary and/or bronchobiliary fistula is a rare but potentially life threatening complication of hepatic hydatid cyst. We report a case of a trans-diaphragm...
EFFECTS OF LIFESTYLE MODIFICATION ON FETOMATERNAL OUTCOME IN ANTENATAL WOMEN WITH INCREASED BMI
BACKGROUND Overweight and obese women represent a significant and increasing problem encountered in obstetric practice. With most authors agreeing that overweight and obese women show increased maternal and perinatal mor...
A PROSPECTIVE, OBSERVATIONAL STUDY TO UNDERSTAND THE DRUG USAGE COMPOSITION OF ANTI-DIABETIC MEDICATIONS IN A RURAL CENTRE IN KERALA
BACKGROUND With exponentially higher number of patients being diagnosed with diabetes in India, it has gained an epidemic status here.1,2 Globally, the prevalence of diabetes in 2030 is expected to be almost double that...
LEVELS OF SERUM MAGNESIUM IN NORMAL PERSONS AND PERSONS SUFFERING FROM VIRAL HEPATITIS AND DIABETES MELLITUS - A COMPARATIVE STUDY
BACKGROUND The Magnesium is the fourth most abundant cation in the body, second most abundant cation of the intracellular fluid and is known to be intimately associated with a variety of metabolic events. Magnesium is on...
MAXILLOFACIAL INJURIES- AN EIGHT-YEAR STUDY OF 206 PATIENTS
BACKGROUND The aim of our study is to evaluate the incidence and aetiology of maxillofacial injuries in the Department of Plastic Surgery, Srinagar, Kashmir. MATERIALS AND METHODS The study consisted of 206 cases with ma...