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Prediction of difficult laryngoscopy: Extended mallampati score versus the MMT, ULBT and RHTMD.
Adv Biomed Res. 2014; 3:133.AB

Abstract

BACKGROUND

Preoperative using of anatomical landmarks detects potentially difficult laryngoscopies. The main object of the present study was to evaluate the predictive power of Extended Mallampati Score (EMS) in comparison with modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD) and the Upper-Lip-Bite test (ULBT) in isolation and combination.

MATERIALS AND METHODS

Four hundred seventy sixadult patients who candidate for elective surgery under general anesthesia requiring endotracheal intubation were included in this study and evaluated based of all four factors before surgery. This study was randomized prospective double - blind. After that, laryngoscopy was performed by an anesthesiologist who didn't involve in preoperative airway assessment and graded based on Cormack and Lehane's classification. We calculated sensitivity, specificity, and area under receiver-operating characteristic (ROC) (AUC) for each score.

RESULTS

The AUCof the ROC was significantly more for the ULBT (AUC = 0.820, P = 0.049) and RHTMD score (AUC = 0.845, P = 0.033) than the EMS (AUC = 0.703). This variable was significantly higher for the EMS compared with MMT (0.703 vs. 0.569, P = 0.046 respectively). There was no significant difference between the AUC of the ROC for the ULBT and the RHTMD score (P = 0.685). The optimalcut-off point for the RHTMD for predicting difficult laryngoscopy was 29.3.

CONCLUSION

EMS predicted difficult laryngoscopy better than MMT while both ULBT and RHTMD had more power than EMS and MMT in this regard. ULBT and RHTMD had similar predictive value for prediction of difficult laryngoscopy in general population.

Authors+Show Affiliations

Department of Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24949304

Citation

Safavi, Mohammadreza, et al. "Prediction of Difficult Laryngoscopy: Extended Mallampati Score Versus the MMT, ULBT and RHTMD." Advanced Biomedical Research, vol. 3, 2014, p. 133.
Safavi M, Honarmand A, Amoushahi M. Prediction of difficult laryngoscopy: Extended mallampati score versus the MMT, ULBT and RHTMD. Adv Biomed Res. 2014;3:133.
Safavi, M., Honarmand, A., & Amoushahi, M. (2014). Prediction of difficult laryngoscopy: Extended mallampati score versus the MMT, ULBT and RHTMD. Advanced Biomedical Research, 3, 133. https://doi.org/10.4103/2277-9175.133270
Safavi M, Honarmand A, Amoushahi M. Prediction of Difficult Laryngoscopy: Extended Mallampati Score Versus the MMT, ULBT and RHTMD. Adv Biomed Res. 2014;3:133. PubMed PMID: 24949304.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediction of difficult laryngoscopy: Extended mallampati score versus the MMT, ULBT and RHTMD. AU - Safavi,Mohammadreza, AU - Honarmand,Azim, AU - Amoushahi,Mahsa, Y1 - 2014/05/28/ PY - 2012/08/12/received PY - 2012/12/30/accepted PY - 2014/6/21/entrez PY - 2014/6/21/pubmed PY - 2014/6/21/medline KW - Difficult laryngoscopy KW - extended mallampati score KW - modified mallampati KW - ratio of patient's height to thyromental distance KW - upper lip bite test SP - 133 EP - 133 JF - Advanced biomedical research JO - Adv Biomed Res VL - 3 N2 - BACKGROUND: Preoperative using of anatomical landmarks detects potentially difficult laryngoscopies. The main object of the present study was to evaluate the predictive power of Extended Mallampati Score (EMS) in comparison with modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD) and the Upper-Lip-Bite test (ULBT) in isolation and combination. MATERIALS AND METHODS: Four hundred seventy sixadult patients who candidate for elective surgery under general anesthesia requiring endotracheal intubation were included in this study and evaluated based of all four factors before surgery. This study was randomized prospective double - blind. After that, laryngoscopy was performed by an anesthesiologist who didn't involve in preoperative airway assessment and graded based on Cormack and Lehane's classification. We calculated sensitivity, specificity, and area under receiver-operating characteristic (ROC) (AUC) for each score. RESULTS: The AUCof the ROC was significantly more for the ULBT (AUC = 0.820, P = 0.049) and RHTMD score (AUC = 0.845, P = 0.033) than the EMS (AUC = 0.703). This variable was significantly higher for the EMS compared with MMT (0.703 vs. 0.569, P = 0.046 respectively). There was no significant difference between the AUC of the ROC for the ULBT and the RHTMD score (P = 0.685). The optimalcut-off point for the RHTMD for predicting difficult laryngoscopy was 29.3. CONCLUSION: EMS predicted difficult laryngoscopy better than MMT while both ULBT and RHTMD had more power than EMS and MMT in this regard. ULBT and RHTMD had similar predictive value for prediction of difficult laryngoscopy in general population. SN - 2277-9175 UR - https://www.unboundmedicine.com/medline/citation/24949304/Prediction_of_difficult_laryngoscopy:_Extended_mallampati_score_versus_the_MMT_ULBT_and_RHTMD_ L2 - http://www.advbiores.net/article.asp?issn=2277-9175;year=2014;volume=3;issue=1;spage=133;epage=133;aulast=Safavi DB - PRIME DP - Unbound Medicine ER -
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