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Comparison of five methods in predicting difficult laryngoscopy: Neck circumference, neck circumference to thyromental distance ratio, the ratio of height to thyromental distance, upper lip bite test and Mallampati test.
Adv Biomed Res. 2015; 4:122.AB

Abstract

BACKGROUND

Preoperative airway assessment tests have been presented to help in anticipating a difficult airway. We conducted this study to compare five methods in prediction of difficult laryngoscopy: Neck circumference (NC), NC to thyromental distance ratio (NC/TMD), the ratio of height to thyromental distance (RHTMD), upper lip bite test (ULBT) and Mallampati test (MMT). These five methods are the most commonly used ones and have different powers for it. It was not clear which of these methods predicts difficult laryngoscopy better.

MATERIALS AND METHODS

Six hundred consecutive patients participated in this study. NC, NC/TMD and RHTMD were measured, and ULBT and MMT were performed and recorded. The laryngoscopy view was graded according to Cormack and Lehane's scale (CLS) and difficult laryngoscopy was defined as CLS grades 3 and 4. Accuracy of tests in predicting difficult laryngoscopy was assessed using the area under a receiver-operating characteristic curve.

RESULTS

The area under the curve in ULBT and RHTMD were significantly larger than that in TMD, NC and MMT. No statistically significant differences were noted between TMD, NC and MMT (all P > 0.05) (ULBT = RHTMD > NC/TMD > TMD = NC = MMT). RHTMD (>22.7 cm) exhibited the highest sensitivity (sensitivity = 64.77, 95% confidence interval [CI]: 53.9-74.7) and the most specific test was ULBT (specificity = 99.41%, 95% CI: 98.3-99.9).

CONCLUSION

RHTMD and ULBT as simple preoperative bedside tests have a higher level of accuracy compared to NC/TMD, TMD, NC, MMT in predicting a difficult airway.

Authors+Show Affiliations

Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Emergency Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26261824

Citation

Honarmand, Azim, et al. "Comparison of Five Methods in Predicting Difficult Laryngoscopy: Neck Circumference, Neck Circumference to Thyromental Distance Ratio, the Ratio of Height to Thyromental Distance, Upper Lip Bite Test and Mallampati Test." Advanced Biomedical Research, vol. 4, 2015, p. 122.
Honarmand A, Safavi M, Yaraghi A, et al. Comparison of five methods in predicting difficult laryngoscopy: Neck circumference, neck circumference to thyromental distance ratio, the ratio of height to thyromental distance, upper lip bite test and Mallampati test. Adv Biomed Res. 2015;4:122.
Honarmand, A., Safavi, M., Yaraghi, A., Attari, M., Khazaei, M., & Zamani, M. (2015). Comparison of five methods in predicting difficult laryngoscopy: Neck circumference, neck circumference to thyromental distance ratio, the ratio of height to thyromental distance, upper lip bite test and Mallampati test. Advanced Biomedical Research, 4, 122. https://doi.org/10.4103/2277-9175.158033
Honarmand A, et al. Comparison of Five Methods in Predicting Difficult Laryngoscopy: Neck Circumference, Neck Circumference to Thyromental Distance Ratio, the Ratio of Height to Thyromental Distance, Upper Lip Bite Test and Mallampati Test. Adv Biomed Res. 2015;4:122. PubMed PMID: 26261824.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of five methods in predicting difficult laryngoscopy: Neck circumference, neck circumference to thyromental distance ratio, the ratio of height to thyromental distance, upper lip bite test and Mallampati test. AU - Honarmand,Azim, AU - Safavi,Mohammadreza, AU - Yaraghi,Ahmad, AU - Attari,Mohammadali, AU - Khazaei,Mehdi, AU - Zamani,Majid, Y1 - 2015/06/04/ PY - 2014/02/16/received PY - 2015/01/22/accepted PY - 2015/8/12/entrez PY - 2015/8/12/pubmed PY - 2015/8/12/medline KW - Airway management KW - intubation KW - laryngoscopy SP - 122 EP - 122 JF - Advanced biomedical research JO - Adv Biomed Res VL - 4 N2 - BACKGROUND: Preoperative airway assessment tests have been presented to help in anticipating a difficult airway. We conducted this study to compare five methods in prediction of difficult laryngoscopy: Neck circumference (NC), NC to thyromental distance ratio (NC/TMD), the ratio of height to thyromental distance (RHTMD), upper lip bite test (ULBT) and Mallampati test (MMT). These five methods are the most commonly used ones and have different powers for it. It was not clear which of these methods predicts difficult laryngoscopy better. MATERIALS AND METHODS: Six hundred consecutive patients participated in this study. NC, NC/TMD and RHTMD were measured, and ULBT and MMT were performed and recorded. The laryngoscopy view was graded according to Cormack and Lehane's scale (CLS) and difficult laryngoscopy was defined as CLS grades 3 and 4. Accuracy of tests in predicting difficult laryngoscopy was assessed using the area under a receiver-operating characteristic curve. RESULTS: The area under the curve in ULBT and RHTMD were significantly larger than that in TMD, NC and MMT. No statistically significant differences were noted between TMD, NC and MMT (all P > 0.05) (ULBT = RHTMD > NC/TMD > TMD = NC = MMT). RHTMD (>22.7 cm) exhibited the highest sensitivity (sensitivity = 64.77, 95% confidence interval [CI]: 53.9-74.7) and the most specific test was ULBT (specificity = 99.41%, 95% CI: 98.3-99.9). CONCLUSION: RHTMD and ULBT as simple preoperative bedside tests have a higher level of accuracy compared to NC/TMD, TMD, NC, MMT in predicting a difficult airway. SN - 2277-9175 UR - https://www.unboundmedicine.com/medline/citation/26261824/Comparison_of_five_methods_in_predicting_difficult_laryngoscopy:_Neck_circumference_neck_circumference_to_thyromental_distance_ratio_the_ratio_of_height_to_thyromental_distance_upper_lip_bite_test_and_Mallampati_test_ L2 - http://www.advbiores.net/article.asp?issn=2277-9175;year=2015;volume=4;issue=1;spage=122;epage=122;aulast=Honarmand DB - PRIME DP - Unbound Medicine ER -
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