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
Identifieur interne : 000F31 ( Pmc/Checkpoint ); précédent : 000F30; suivant : 000F32Comparison 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
Auteurs : Azim Honarmand [Iran] ; Mohammadreza Safavi [Iran] ; Ahmad Yaraghi [Iran] ; Mohammadali Attari [Iran] ; Mehdi Khazaei [Iran] ; Majid Zamani [Iran]Source :
- Advanced Biomedical Research [ 2277-9175 ] ; 2015.
Abstract
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.
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.
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
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.
Url:
DOI: 10.4103/2277-9175.158033
PubMed: 26261824
PubMed Central: 4513312
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">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</title><author><name sortKey="Honarmand, Azim" sort="Honarmand, Azim" uniqKey="Honarmand A" first="Azim" last="Honarmand">Azim Honarmand</name><affiliation wicri:level="1"><nlm:aff id="aff1">Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Safavi, Mohammadreza" sort="Safavi, Mohammadreza" uniqKey="Safavi M" first="Mohammadreza" last="Safavi">Mohammadreza Safavi</name><affiliation wicri:level="1"><nlm:aff id="aff1">Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Yaraghi, Ahmad" sort="Yaraghi, Ahmad" uniqKey="Yaraghi A" first="Ahmad" last="Yaraghi">Ahmad Yaraghi</name><affiliation wicri:level="1"><nlm:aff id="aff1">Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Attari, Mohammadali" sort="Attari, Mohammadali" uniqKey="Attari M" first="Mohammadali" last="Attari">Mohammadali Attari</name><affiliation wicri:level="1"><nlm:aff id="aff1">Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Khazaei, Mehdi" sort="Khazaei, Mehdi" uniqKey="Khazaei M" first="Mehdi" last="Khazaei">Mehdi Khazaei</name><affiliation wicri:level="1"><nlm:aff id="aff1">Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Zamani, Majid" sort="Zamani, Majid" uniqKey="Zamani M" first="Majid" last="Zamani">Majid Zamani</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Emergency Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Emergency Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26261824</idno><idno type="pmc">4513312</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513312</idno><idno type="RBID">PMC:4513312</idno><idno type="doi">10.4103/2277-9175.158033</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000253</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000253</idno><idno type="wicri:Area/Pmc/Curation">000253</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000253</idno><idno type="wicri:Area/Pmc/Checkpoint">000F31</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000F31</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">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</title><author><name sortKey="Honarmand, Azim" sort="Honarmand, Azim" uniqKey="Honarmand A" first="Azim" last="Honarmand">Azim Honarmand</name><affiliation wicri:level="1"><nlm:aff id="aff1">Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Safavi, Mohammadreza" sort="Safavi, Mohammadreza" uniqKey="Safavi M" first="Mohammadreza" last="Safavi">Mohammadreza Safavi</name><affiliation wicri:level="1"><nlm:aff id="aff1">Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Yaraghi, Ahmad" sort="Yaraghi, Ahmad" uniqKey="Yaraghi A" first="Ahmad" last="Yaraghi">Ahmad Yaraghi</name><affiliation wicri:level="1"><nlm:aff id="aff1">Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Attari, Mohammadali" sort="Attari, Mohammadali" uniqKey="Attari M" first="Mohammadali" last="Attari">Mohammadali Attari</name><affiliation wicri:level="1"><nlm:aff id="aff1">Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Khazaei, Mehdi" sort="Khazaei, Mehdi" uniqKey="Khazaei M" first="Mehdi" last="Khazaei">Mehdi Khazaei</name><affiliation wicri:level="1"><nlm:aff id="aff1">Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Zamani, Majid" sort="Zamani, Majid" uniqKey="Zamani M" first="Majid" last="Zamani">Majid Zamani</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Emergency Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Emergency Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author></analytic><series><title level="j">Advanced Biomedical Research</title><idno type="eISSN">2277-9175</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title><p>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.</p></sec><sec id="st2"><title>Materials and Methods:</title><p>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.</p></sec><sec id="st3"><title>Results:</title><p>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 <italic>P</italic> > 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).</p></sec><sec id="st4"><title>Conclusion:</title><p>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.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Peterson, Gn" uniqKey="Peterson G">GN Peterson</name></author><author><name sortKey="Domino, Kb" uniqKey="Domino K">KB Domino</name></author><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="Lee, La" uniqKey="Lee L">LA Lee</name></author><author><name sortKey="Cheney, Fw" uniqKey="Cheney F">FW 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Adv Biomed Res</journal-id><journal-id journal-id-type="iso-abbrev">Adv Biomed Res</journal-id><journal-id journal-id-type="publisher-id">ABR</journal-id><journal-title-group><journal-title>Advanced Biomedical Research</journal-title></journal-title-group><issn pub-type="epub">2277-9175</issn><publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name><publisher-loc>India</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26261824</article-id><article-id pub-id-type="pmc">4513312</article-id><article-id pub-id-type="publisher-id">ABR-4-122</article-id><article-id pub-id-type="doi">10.4103/2277-9175.158033</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>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</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Honarmand</surname><given-names>Azim</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Safavi</surname><given-names>Mohammadreza</given-names></name><xref ref-type="aff" rid="aff1"></xref><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Yaraghi</surname><given-names>Ahmad</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Attari</surname><given-names>Mohammadali</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Khazaei</surname><given-names>Mehdi</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Zamani</surname><given-names>Majid</given-names></name><xref ref-type="aff" rid="aff2">1</xref></contrib></contrib-group><aff id="aff1">Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</aff><aff id="aff2"><label>1</label>Department of Emergency Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran</aff><author-notes><corresp id="cor1"><bold>Address for correspondence:</bold> Prof. Mohammadreza Safavi, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail: <email xlink:href="safavi@med.mui.ac.ir">safavi@med.mui.ac.ir</email></corresp></author-notes><pub-date pub-type="collection"><year>2015</year></pub-date><pub-date pub-type="epub"><day>04</day><month>6</month><year>2015</year></pub-date><volume>4</volume><elocation-id>122</elocation-id><history><date date-type="received"><day>16</day><month>2</month><year>2014</year></date><date date-type="accepted"><day>22</day><month>1</month><year>2015</year></date></history><permissions><copyright-statement>Copyright: © 2015 Honarmand.</copyright-statement><copyright-year>2015</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><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 author and source are credited.</license-p></license></permissions><abstract><sec id="st1"><title>Background:</title><p>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.</p></sec><sec id="st2"><title>Materials and Methods:</title><p>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.</p></sec><sec id="st3"><title>Results:</title><p>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 <italic>P</italic> > 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).</p></sec><sec id="st4"><title>Conclusion:</title><p>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.</p></sec></abstract><kwd-group><kwd>Airway management</kwd><kwd>intubation</kwd><kwd>laryngoscopy</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>Iran</li></country></list><tree><country name="Iran"><noRegion><name sortKey="Honarmand, Azim" sort="Honarmand, Azim" uniqKey="Honarmand A" first="Azim" last="Honarmand">Azim Honarmand</name></noRegion><name sortKey="Attari, Mohammadali" sort="Attari, Mohammadali" uniqKey="Attari M" first="Mohammadali" last="Attari">Mohammadali Attari</name><name sortKey="Khazaei, Mehdi" sort="Khazaei, Mehdi" uniqKey="Khazaei M" first="Mehdi" last="Khazaei">Mehdi Khazaei</name><name sortKey="Safavi, Mohammadreza" sort="Safavi, Mohammadreza" uniqKey="Safavi M" first="Mohammadreza" last="Safavi">Mohammadreza Safavi</name><name sortKey="Yaraghi, Ahmad" sort="Yaraghi, Ahmad" uniqKey="Yaraghi A" first="Ahmad" last="Yaraghi">Ahmad Yaraghi</name><name sortKey="Zamani, Majid" sort="Zamani, Majid" uniqKey="Zamani M" first="Majid" last="Zamani">Majid Zamani</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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