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A comparison of the ratio of patient's height to thyromental distance with the modified Mallampati and the upper lip bite test in predicting difficult laryngoscopy.
Saudi J Anaesth. 2011 Jul; 5(3):258-63.SJ

Abstract

BACKGROUND

THE AIM OF THE PRESENT STUDY WAS TO COMPARE THE ABILITY TO PREDICT DIFFICULT VISUALIZATION OF THE LARYNX FROM THE FOLLOWING PREOPERATIVE AIRWAY PREDICTIVE INDICES, IN ISOLATION AND COMBINATION: modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD) and the Upper-Lip-Bite test (ULBT).

METHODS

We collected data on 603 consecutive patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation and then evaluated all three factors before surgery. An experienced anesthesiologist, not informed of the recorded preoperative airway evaluation, performed the laryngoscopy and grading (as per Cormack and Lehane's classification). Sensitivity, specificity, and positive and negative predictive value, Receiver operating characteristic (ROC) Curve and the area under ROC curve (AUC) for each airway predictor in isolation and in combination were determined.

RESULTS

Difficult laryngoscopy (Grade 3 or 4) occurred in 41 (6.8%) patients. The main endpoint of the present study, the AUC of the ROC, was significantly lower for the MMT (AUC, 0.511; 95% CI, 0.470-0.552) than the ULBT (AUC, 0.709; 95% CI, 0.671-0.745, P=0.002) and the RHTMD score (AUC, 0.711; 95% CI, 0.673-0.747, P=0.001). There was no significant difference between the AUC of the ROC for the ULBT and the RHTMD score. By using discrimination analysis, the optimal cutoff point for the RHTMD for predicting difficult laryngoscopy was 21.06 (sensitivity, 75.6%; specificity, 58.5%).

CONCLUSION

The RHTMD is comparable with ULBT for prediction of difficult laryngoscopy in general population.

Authors+Show Affiliations

Departments of Anesthesiology and Critical Care, Alzahra and Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21957403

Citation

Safavi, Mohammadreza, et al. "A Comparison of the Ratio of Patient's Height to Thyromental Distance With the Modified Mallampati and the Upper Lip Bite Test in Predicting Difficult Laryngoscopy." Saudi Journal of Anaesthesia, vol. 5, no. 3, 2011, pp. 258-63.
Safavi M, Honarmand A, Zare N. A comparison of the ratio of patient's height to thyromental distance with the modified Mallampati and the upper lip bite test in predicting difficult laryngoscopy. Saudi J Anaesth. 2011;5(3):258-63.
Safavi, M., Honarmand, A., & Zare, N. (2011). A comparison of the ratio of patient's height to thyromental distance with the modified Mallampati and the upper lip bite test in predicting difficult laryngoscopy. Saudi Journal of Anaesthesia, 5(3), 258-63. https://doi.org/10.4103/1658-354X.84098
Safavi M, Honarmand A, Zare N. A Comparison of the Ratio of Patient's Height to Thyromental Distance With the Modified Mallampati and the Upper Lip Bite Test in Predicting Difficult Laryngoscopy. Saudi J Anaesth. 2011;5(3):258-63. PubMed PMID: 21957403.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of the ratio of patient's height to thyromental distance with the modified Mallampati and the upper lip bite test in predicting difficult laryngoscopy. AU - Safavi,Mohammadreza, AU - Honarmand,Azim, AU - Zare,Narges, PY - 2011/9/30/entrez PY - 2011/10/1/pubmed PY - 2011/10/1/medline KW - Difficult laryngoscopy KW - RHTMD KW - ULBT KW - endotracheal intubation KW - thyromental distance SP - 258 EP - 63 JF - Saudi journal of anaesthesia JO - Saudi J Anaesth VL - 5 IS - 3 N2 - BACKGROUND: THE AIM OF THE PRESENT STUDY WAS TO COMPARE THE ABILITY TO PREDICT DIFFICULT VISUALIZATION OF THE LARYNX FROM THE FOLLOWING PREOPERATIVE AIRWAY PREDICTIVE INDICES, IN ISOLATION AND COMBINATION: modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD) and the Upper-Lip-Bite test (ULBT). METHODS: We collected data on 603 consecutive patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation and then evaluated all three factors before surgery. An experienced anesthesiologist, not informed of the recorded preoperative airway evaluation, performed the laryngoscopy and grading (as per Cormack and Lehane's classification). Sensitivity, specificity, and positive and negative predictive value, Receiver operating characteristic (ROC) Curve and the area under ROC curve (AUC) for each airway predictor in isolation and in combination were determined. RESULTS: Difficult laryngoscopy (Grade 3 or 4) occurred in 41 (6.8%) patients. The main endpoint of the present study, the AUC of the ROC, was significantly lower for the MMT (AUC, 0.511; 95% CI, 0.470-0.552) than the ULBT (AUC, 0.709; 95% CI, 0.671-0.745, P=0.002) and the RHTMD score (AUC, 0.711; 95% CI, 0.673-0.747, P=0.001). There was no significant difference between the AUC of the ROC for the ULBT and the RHTMD score. By using discrimination analysis, the optimal cutoff point for the RHTMD for predicting difficult laryngoscopy was 21.06 (sensitivity, 75.6%; specificity, 58.5%). CONCLUSION: The RHTMD is comparable with ULBT for prediction of difficult laryngoscopy in general population. SN - 0975-3125 UR - https://www.unboundmedicine.com/medline/citation/21957403/A_comparison_of_the_ratio_of_patient's_height_to_thyromental_distance_with_the_modified_Mallampati_and_the_upper_lip_bite_test_in_predicting_difficult_laryngoscopy_ L2 - http://www.saudija.org/article.asp?issn=1658-354X;year=2011;volume=5;issue=3;spage=258;epage=263;aulast=Safavi DB - PRIME DP - Unbound Medicine ER -
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