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
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