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A comparison of between hyomental distance ratios, ratio of height to thyromental, modified Mallamapati classification test and upper lip bite test in predicting difficult laryngoscopy of patients undergoing general anesthesia.
Adv Biomed Res. 2014; 3:166.AB

Abstract

BACKGROUND

Failed intubation is imperative source of anesthetic interrelated patient's mortality. The aim of this present study was to compare the ability to predict difficult visualization of the larynx from the following pre-operative airway predictive indices, in isolation and combination: Modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD), hyomental distance ratios (HMDR), and the upper-lip-bite test (ULBT).

MATERIALS AND METHODS

We collected data on 525 consecutive patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation and then evaluated all four factors before surgery. A skilled anesthesiologist, not imparted of the noted pre-operative airway assessment, did the laryngoscopy and rating (as per Cormack and Lehane's classification). Sensitivity, specificity, and positive predictive value for every airway predictor in isolation and in combination were established.

RESULTS

The most sensitive of the single tests was ULBT with a sensitivity of 90.2%. The hyomental distance extreme of head extension was the least sensitive of the single tests with a sensitivity of 56.9. The HMDR had sensitivity 86.3%. The ULBT had the highest negative predictive value: And the area under a receiver-operating characteristic curve (AUC of ROC curve) among single predictors. The AUC of ROC curve for ULBT, HMDR and RHTMD was significantly more than for MMT (P < 0.05). No significant difference was noted in the AUC of ROC curve for ULBT, HMDR, and RHTMD (P > 0.05).

CONCLUSION

The HMDR is comparable with RHTMD and ULBT for prediction of difficult laryngoscopy in the general population, but was significantly more than for MMT.

Authors+Show Affiliations

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

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25221769

Citation

Honarmand, Azim, et al. "A Comparison of Between Hyomental Distance Ratios, Ratio of Height to Thyromental, Modified Mallamapati Classification Test and Upper Lip Bite Test in Predicting Difficult Laryngoscopy of Patients Undergoing General Anesthesia." Advanced Biomedical Research, vol. 3, 2014, p. 166.
Honarmand A, Safavi M, Ansari N. A comparison of between hyomental distance ratios, ratio of height to thyromental, modified Mallamapati classification test and upper lip bite test in predicting difficult laryngoscopy of patients undergoing general anesthesia. Adv Biomed Res. 2014;3:166.
Honarmand, A., Safavi, M., & Ansari, N. (2014). A comparison of between hyomental distance ratios, ratio of height to thyromental, modified Mallamapati classification test and upper lip bite test in predicting difficult laryngoscopy of patients undergoing general anesthesia. Advanced Biomedical Research, 3, 166. https://doi.org/10.4103/2277-9175.139130
Honarmand A, Safavi M, Ansari N. A Comparison of Between Hyomental Distance Ratios, Ratio of Height to Thyromental, Modified Mallamapati Classification Test and Upper Lip Bite Test in Predicting Difficult Laryngoscopy of Patients Undergoing General Anesthesia. Adv Biomed Res. 2014;3:166. PubMed PMID: 25221769.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of between hyomental distance ratios, ratio of height to thyromental, modified Mallamapati classification test and upper lip bite test in predicting difficult laryngoscopy of patients undergoing general anesthesia. AU - Honarmand,Azim, AU - Safavi,Mohammadreza, AU - Ansari,Narges, Y1 - 2014/08/19/ PY - 2012/12/07/received PY - 2013/05/01/accepted PY - 2014/9/16/entrez PY - 2014/9/16/pubmed PY - 2014/9/16/medline KW - Failed intubation KW - hyomental distance ratios KW - laryngoscopy KW - modified Mallampati test KW - ratio of height to thyromental distance KW - upper-lip-bite test SP - 166 EP - 166 JF - Advanced biomedical research JO - Adv Biomed Res VL - 3 N2 - BACKGROUND: Failed intubation is imperative source of anesthetic interrelated patient's mortality. The aim of this present study was to compare the ability to predict difficult visualization of the larynx from the following pre-operative airway predictive indices, in isolation and combination: Modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD), hyomental distance ratios (HMDR), and the upper-lip-bite test (ULBT). MATERIALS AND METHODS: We collected data on 525 consecutive patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation and then evaluated all four factors before surgery. A skilled anesthesiologist, not imparted of the noted pre-operative airway assessment, did the laryngoscopy and rating (as per Cormack and Lehane's classification). Sensitivity, specificity, and positive predictive value for every airway predictor in isolation and in combination were established. RESULTS: The most sensitive of the single tests was ULBT with a sensitivity of 90.2%. The hyomental distance extreme of head extension was the least sensitive of the single tests with a sensitivity of 56.9. The HMDR had sensitivity 86.3%. The ULBT had the highest negative predictive value: And the area under a receiver-operating characteristic curve (AUC of ROC curve) among single predictors. The AUC of ROC curve for ULBT, HMDR and RHTMD was significantly more than for MMT (P < 0.05). No significant difference was noted in the AUC of ROC curve for ULBT, HMDR, and RHTMD (P > 0.05). CONCLUSION: The HMDR is comparable with RHTMD and ULBT for prediction of difficult laryngoscopy in the general population, but was significantly more than for MMT. SN - 2277-9175 UR - https://www.unboundmedicine.com/medline/citation/25221769/A_comparison_of_between_hyomental_distance_ratios_ratio_of_height_to_thyromental_modified_Mallamapati_classification_test_and_upper_lip_bite_test_in_predicting_difficult_laryngoscopy_of_patients_undergoing_general_anesthesia_ L2 - http://www.advbiores.net/article.asp?issn=2277-9175;year=2014;volume=3;issue=1;spage=166;epage=166;aulast=Honarmand DB - PRIME DP - Unbound Medicine ER -
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