Original ContributionEvaluation of the reliability of preoperative descriptive airway assessment tests in prediction of the Cormack-Lehane score: A prospective randomized clinical study☆
Section snippets
Introductıon
Appropriate management of the difficult airway constitutes an important place in the prevention of mortality and morbidity associated with anesthesia. The prevalence of difficult laryngoscopy has been reported to range between 1.5% and 20%, and a variety of physical examination tests have been used to estimate its presence [1]. One of the most frequently used tests in the assessment of airway is Mallampati scoring, while a variety of methods including thyromental distance, mouth opening,
Materials and methods
This study was conducted between February 2015 and August 2015 after obtaining approval from Maltepe University Medical Faculty (Istanbul) ethics committee on 29 May 2014 with protocol number 23. A total of 451 male and female patients over 18 years of age, who would undergo surgical operation under general anesthesia were included in the study; written consents of the patients were obtained. The patients were selected in the preoperative according to a randomization principle of “the first
Results
The demographic data of the participants are shown in Table 1. A total of 451 patients (221 women and 230 men, age 17–94 y) were included in the study. A total of 37 (8.2%) patients were defined as difficult intubation according to the C-L grade 3 and grade 4 laryngeal views. None of the patients had failed endotracheal intubation. Age and American Society of Anesthesiologists (ASA) score scores of the patients who were classified as difficult intubation were significantly higher (Table 2).
Discussion
The tests that are used to predict difficult intubation are expected to have high sensitivity and specificity and minimal false positive and false negative values [6]. There is still no available single standard method that meets the criteria or a consensus regarding the reliability of the ideally preferred tests [7], [8]. Etezadi et al [1] suggested that TMH was a promising single anatomical measurement technique with high sensitivity, specificity, PPV and NPV (82.6%, 99.31%, 90.47% and 98.63%
Conclusion
Airway screening tests should be simple, convenient and practical. They are an essential tool for anesthesiologists despite the fact that their validity is variable and their ability to predict unexpected difficult intubations remains restricted.
The present study demonstrates the practicality of TMH as a digitalized test. It also confirms the relatively high sensitivity of TMH for predicting difficult intubation; however, in not replicating the clear-cut results of the previous study, the
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Disclosure: There is no funding for this study and we do not have any conflict of interest.