International Journal of Medical Anesthesiology
2019, Vol. 2, Issue 2, Part B
Airway assessment factors as a predictive marker of difficult direct laryngoscopy: A prospective study
Author(s): Dr. Bhavana Harwani, Dr. Selvakumaran Pannirselvam, Dr. PS Shanmugham and Dr. UG Thirumaaran
Abstract: Background and objectives: Preoperative evaluation of anatomical landmarks help identify potentially difficult laryngoscopies; however, predictive reliability is unclear. Thus, this study was undertaken to identify and compare the most reliable variables, in prediction of difficult direct laryngoscopy.
Methodology: Pre-operative assessment of ten parameters using clinical and goniometric measurement were taken and consecutively predictors of difficult intubation were identified. On the day of surgery, after premedication and induction, laryngoscopy was performed. The glottic views were graded according to the Cormack and Lehane classification. Patients of Cormack Lehane class II B and above were considered as difficult to intubate.
Results: 15.4% of the cases were identified as difficult intubation. Cormack and Lehane classification had the highest diagnostic accuracy followed by Thyromental distance, sternomental distance and Modified Mallampati classification in that order. Mandibular-hyoid distance had highest sensitivity. when all ten parameters were taken into consideration, 95.7% of cases were classified correctly. Also, it classified correctly 97.7% of easy and 84.2% difficult intubation.
Conclusion: Apart from Cormack-Lehane grading, upon comparison of all the parameters, a combination of Thyromental distance, Atlanto-occipital joint extension and Modified Mallampati classification were able to correctly classify 95.3% of difficult intubation.
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How to cite this article:
Dr. Bhavana Harwani, Dr. Selvakumaran Pannirselvam, Dr. PS Shanmugham, Dr. UG Thirumaaran. Airway assessment factors as a predictive marker of difficult direct laryngoscopy: A prospective study. Int J Med Anesthesiology 2019;2(2):84-88. DOI: 10.33545/26643766.2019.v2.i2b.34