A comparison of the upper lip bite test with hyomental/thyrosternal distances and mandible length in predicting difficulty in intubation: A prospective study
Identifieur interne : 003521 ( Ncbi/Merge ); précédent : 003520; suivant : 003522A comparison of the upper lip bite test with hyomental/thyrosternal distances and mandible length in predicting difficulty in intubation: A prospective study
Auteurs : Zahid Hussain Khan [Iran] ; Anahid Maleki [Iran] ; Jalil Makarem [Iran] ; Mostafa Mohammadi [Iran] ; Ramooz Hussain Khan [Hongrie] ; Ali Zandieh [Iran]Source :
- Indian Journal of Anaesthesia [ 0019-5049 ] ; 2011.
Abstract
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,
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DOI: 10.4103/0019-5049.76603
PubMed: 21431052
PubMed Central: 3057244
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wicri:level="1"><nlm:aff id="AF0001">Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Centre, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Centre, Tehran University of Medical Sciences, Tehran</wicri:regionArea><wicri:noRegion>Tehran</wicri:noRegion></affiliation></author><author><name sortKey="Maleki, Anahid" sort="Maleki, Anahid" uniqKey="Maleki A" first="Anahid" last="Maleki">Anahid Maleki</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Centre, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Centre, Tehran University of Medical Sciences, Tehran</wicri:regionArea><wicri:noRegion>Tehran</wicri:noRegion></affiliation></author><author><name sortKey="Makarem, Jalil" sort="Makarem, Jalil" uniqKey="Makarem J" first="Jalil" last="Makarem">Jalil Makarem</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Centre, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Centre, Tehran University of Medical Sciences, Tehran</wicri:regionArea><wicri:noRegion>Tehran</wicri:noRegion></affiliation></author><author><name sortKey="Mohammadi, Mostafa" sort="Mohammadi, Mostafa" uniqKey="Mohammadi M" first="Mostafa" last="Mohammadi">Mostafa Mohammadi</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Centre, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Centre, Tehran University of Medical Sciences, Tehran</wicri:regionArea><wicri:noRegion>Tehran</wicri:noRegion></affiliation></author><author><name sortKey="Khan, Ramooz Hussain" sort="Khan, Ramooz Hussain" uniqKey="Khan R" first="Ramooz Hussain" last="Khan">Ramooz Hussain Khan</name><affiliation wicri:level="1"><nlm:aff id="AF0002">Department of Dentistry, Debrecen Medical University, Hungary</nlm:aff><country xml:lang="fr">Hongrie</country><wicri:regionArea>Department of Dentistry, Debrecen Medical University</wicri:regionArea><wicri:noRegion>Debrecen Medical University</wicri:noRegion></affiliation></author><author><name sortKey="Zandieh, Ali" sort="Zandieh, Ali" uniqKey="Zandieh A" first="Ali" last="Zandieh">Ali Zandieh</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Centre, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Centre, Tehran University of Medical Sciences, Tehran</wicri:regionArea><wicri:noRegion>Tehran</wicri:noRegion></affiliation></author></analytic><series><title level="j">Indian Journal of Anaesthesia</title><idno type="ISSN">0019-5049</idno><idno type="eISSN">0976-2817</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>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, <italic>P</italic> < 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.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Caplan, Ra" uniqKey="Caplan R">RA Caplan</name></author><author><name sortKey="Posner, Kl" uniqKey="Posner K">KL Posner</name></author><author><name sortKey="Ward, Rj" uniqKey="Ward R">RJ Ward</name></author><author><name sortKey="Cheney, Fw" uniqKey="Cheney F">FW Cheney</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Benumof, Jl" uniqKey="Benumof J">JL Benumof</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wilson, Me" uniqKey="Wilson M">ME Wilson</name></author><author><name sortKey="Spiegelhalter, D" uniqKey="Spiegelhalter D">D Spiegelhalter</name></author><author><name sortKey="Robertson, Ja" uniqKey="Robertson J">JA Robertson</name></author><author><name sortKey="Lesser, P" uniqKey="Lesser P">P 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article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Indian J Anaesth</journal-id><journal-id journal-id-type="publisher-id">IJA</journal-id><journal-title-group><journal-title>Indian Journal of Anaesthesia</journal-title></journal-title-group><issn pub-type="ppub">0019-5049</issn><issn pub-type="epub">0976-2817</issn><publisher><publisher-name>Medknow Publications</publisher-name><publisher-loc>India</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21431052</article-id><article-id pub-id-type="pmc">3057244</article-id><article-id pub-id-type="publisher-id">IJA-55-43</article-id><article-id pub-id-type="doi">10.4103/0019-5049.76603</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical Investigation</subject></subj-group></article-categories><title-group><article-title>A comparison of the upper lip bite test with hyomental/thyrosternal distances and mandible length in predicting difficulty in intubation: A prospective study</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Khan</surname><given-names>Zahid Hussain</given-names></name><xref ref-type="aff" rid="AF0001"></xref><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Maleki</surname><given-names>Anahid</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib><contrib contrib-type="author"><name><surname>Makarem</surname><given-names>Jalil</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib><contrib contrib-type="author"><name><surname>Mohammadi</surname><given-names>Mostafa</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib><contrib contrib-type="author"><name><surname>Khan</surname><given-names>Ramooz Hussain</given-names></name><xref ref-type="aff" rid="AF0002">1</xref></contrib><contrib contrib-type="author"><name><surname>Zandieh</surname><given-names>Ali</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib></contrib-group><aff id="AF0001">Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Centre, Tehran University of Medical Sciences, Tehran, Iran</aff><aff id="AF0002"><label>1</label>Department of Dentistry, Debrecen Medical University, Hungary</aff><author-notes><corresp id="cor1"><bold>Address for correspondence:</bold> Dr. Zahid Hussain Khan, Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Centre, Keshavarz Bld, Tehran, Iran. E-mail: <email xlink:href="khanzh51@yahoo.com">khanzh51@yahoo.com</email></corresp></author-notes><pub-date pub-type="ppub"><season>Jan-Feb</season><year>2011</year></pub-date><volume>55</volume><issue>1</issue><fpage>43</fpage><lpage>46</lpage><permissions><copyright-statement>© Indian Journal of Anaesthesia</copyright-statement><copyright-year>2011</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>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, <italic>P</italic> < 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.</p></abstract><kwd-group><kwd>Difficult intubation</kwd><kwd>difficult laryngoscopy</kwd><kwd>endotracheal intubation</kwd><kwd>predictive airway tests</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>Hongrie</li><li>Iran</li></country></list><tree><country name="Iran"><noRegion><name sortKey="Khan, Zahid Hussain" sort="Khan, Zahid Hussain" uniqKey="Khan Z" first="Zahid Hussain" last="Khan">Zahid Hussain Khan</name></noRegion><name sortKey="Makarem, Jalil" sort="Makarem, Jalil" uniqKey="Makarem J" first="Jalil" last="Makarem">Jalil Makarem</name><name sortKey="Maleki, Anahid" sort="Maleki, Anahid" uniqKey="Maleki A" first="Anahid" last="Maleki">Anahid Maleki</name><name sortKey="Mohammadi, Mostafa" sort="Mohammadi, Mostafa" uniqKey="Mohammadi M" first="Mostafa" last="Mohammadi">Mostafa Mohammadi</name><name sortKey="Zandieh, Ali" sort="Zandieh, Ali" uniqKey="Zandieh A" first="Ali" last="Zandieh">Ali Zandieh</name></country><country name="Hongrie"><noRegion><name sortKey="Khan, Ramooz Hussain" sort="Khan, Ramooz Hussain" uniqKey="Khan R" first="Ramooz Hussain" last="Khan">Ramooz Hussain Khan</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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