A comparison of the upper lip bite test with hyomental/thyrosternal distances and mandible length in predicting difficulty in intubation: A prospective study
The incidence of difficulty in tracheal intubation has been reported to range from 0.5 to 18% in patients undergoing surgery. We aimed to elucidate the role of upper lip bite test (ULBT) with other prevailing tests, hyomental/thyrosternal distances (HMD/TSD), and the mandible length (ML) and their p...
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2011-01-01
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doaj-ad60d1d8892341f79d4cb7fa1b9210c92020-11-24T21:07:16ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50492011-01-01551434610.4103/0019-5049.76603A comparison of the upper lip bite test with hyomental/thyrosternal distances and mandible length in predicting difficulty in intubation: A prospective studyZahid Hussain KhanAnahid MalekiJalil MakaremMostafa MohammadiRamooz Hussain KhanAli ZandiehThe incidence of difficulty in tracheal intubation has been reported to range from 0.5 to 18% in patients undergoing surgery. We aimed to elucidate the role of upper lip bite test (ULBT) with other prevailing tests, hyomental/thyrosternal distances (HMD/TSD), and the mandible length (ML) and their possible correlation in predicting difficulty in intubation. After institutional approval and informed consent were obtained, 300 consecutive patients aged 20-60 years of ASA physical status I and II, scheduled for elective surgical procedures requiring tracheal intubation and meeting the inclusion criteria, were enrolled in this study. Each patient was evaluated regarding ULBT, HMD, TSD and ML. Laryngoscopy was assessed by an attending anaesthesiologist blinded to the measurements. The laryngoscopic result was graded according to Cormack and Lehane′s Grading system. The negative predictive value (NPV) and positive predictive value (PPV) of ULBT were found to be 94 and 100%, respectively. These corresponding figures for TSD were 88.5 and 0%, respectively. Specificities for ULBT, HMD, ML and TSD were 100, 98.9, 98.9 and 98.1%, respectively. ULBT class and laryngoscopic grading showed the greatest agreement (kappa = 0.61, P < 0.001). An agreement between laryngoscopic grading and HMD and ML also existed (0.003 and <0.001, respectively), but was comparatively weaker. The high specificity, NPV, PPV and accuracy of ULBT as revealed in this study could be a good rationale for its application in the prediction of difficulty or easiness in intubation. ML > 9 cm and HMD > 3.5 cm were good predictors of negative difficult intubation.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2011;volume=55;issue=1;spage=43;epage=46;aulast=KhanDifficult intubationdifficult laryngoscopyendotracheal intubationpredictive airway tests |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zahid Hussain Khan Anahid Maleki Jalil Makarem Mostafa Mohammadi Ramooz Hussain Khan Ali Zandieh |
spellingShingle |
Zahid Hussain Khan Anahid Maleki Jalil Makarem Mostafa Mohammadi Ramooz Hussain Khan Ali Zandieh A comparison of the upper lip bite test with hyomental/thyrosternal distances and mandible length in predicting difficulty in intubation: A prospective study Indian Journal of Anaesthesia Difficult intubation difficult laryngoscopy endotracheal intubation predictive airway tests |
author_facet |
Zahid Hussain Khan Anahid Maleki Jalil Makarem Mostafa Mohammadi Ramooz Hussain Khan Ali Zandieh |
author_sort |
Zahid Hussain Khan |
title |
A comparison of the upper lip bite test with hyomental/thyrosternal distances and mandible length in predicting difficulty in intubation: A prospective study |
title_short |
A comparison of the upper lip bite test with hyomental/thyrosternal distances and mandible length in predicting difficulty in intubation: A prospective study |
title_full |
A comparison of the upper lip bite test with hyomental/thyrosternal distances and mandible length in predicting difficulty in intubation: A prospective study |
title_fullStr |
A comparison of the upper lip bite test with hyomental/thyrosternal distances and mandible length in predicting difficulty in intubation: A prospective study |
title_full_unstemmed |
A comparison of the upper lip bite test with hyomental/thyrosternal distances and mandible length in predicting difficulty in intubation: A prospective study |
title_sort |
comparison of the upper lip bite test with hyomental/thyrosternal distances and mandible length in predicting difficulty in intubation: a prospective study |
publisher |
Wolters Kluwer Medknow Publications |
series |
Indian Journal of Anaesthesia |
issn |
0019-5049 |
publishDate |
2011-01-01 |
description |
The incidence of difficulty in tracheal intubation has been reported to range from 0.5 to 18% in patients undergoing surgery. We aimed to elucidate the role of upper lip bite test (ULBT) with other prevailing tests, hyomental/thyrosternal distances (HMD/TSD), and the mandible length (ML) and their possible correlation in predicting difficulty in intubation. After institutional approval and informed consent were obtained, 300 consecutive patients aged 20-60 years of ASA physical status I and II, scheduled for elective surgical procedures requiring tracheal intubation and meeting the inclusion criteria, were enrolled in this study. Each patient was evaluated regarding ULBT, HMD, TSD and ML. Laryngoscopy was assessed by an attending anaesthesiologist blinded to the measurements. The laryngoscopic result was graded according to Cormack and Lehane′s Grading system. The negative predictive value (NPV) and positive predictive value (PPV) of ULBT were found to be 94 and 100%, respectively. These corresponding figures for TSD were 88.5 and 0%, respectively. Specificities for ULBT, HMD, ML and TSD were 100, 98.9, 98.9 and 98.1%, respectively. ULBT class and laryngoscopic grading showed the greatest agreement (kappa = 0.61, P < 0.001). An agreement between laryngoscopic grading and HMD and ML also existed (0.003 and <0.001, respectively), but was comparatively weaker. The high specificity, NPV, PPV and accuracy of ULBT as revealed in this study could be a good rationale for its application in the prediction of difficulty or easiness in intubation. ML > 9 cm and HMD > 3.5 cm were good predictors of negative difficult intubation. |
topic |
Difficult intubation difficult laryngoscopy endotracheal intubation predictive airway tests |
url |
http://www.ijaweb.org/article.asp?issn=0019-5049;year=2011;volume=55;issue=1;spage=43;epage=46;aulast=Khan |
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