A clinical sign to predict difficult tracheal intubation; a prospective study

Mallampati, S. Rao; Gatt, Stephen; Gugino, Laverne D.; Desai, Sukumar P.; Waraksa, B.; Freiberger, Dubravka; Liu, Philip L.

doi:10.1007/bf03011357

Cited by 2,091 publications

(954 citation statements)

References 6 publications

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“…In group B (n 5 156), 78 (50%) patients were in class 0 (median score, 3; range, 0-9), 41 (26%) patients were in class I (median score, 3; range, 0-8), 18 (12%) patients were in class II (median score, 5; range, 3-11), 13 (8%) patients were in class III (median score, 6; range, 3-11), and six (4%) patients were in class IV (median score, 7; range, [3][4][5][6][7][8][9][10]. No statistically significant difference was observed in the distribution of patients among different classes between the two institutions.…”

Section: Resultsmentioning

confidence: 99%

Preoperative clinical predictors of difficult laryngeal exposure for microlaryngoscopy: The laryngoscore

Piazza¹,

Mangili²,

Bon³

et al. 2014

The Laryngoscope

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Objectives/Hypothesis: To identify a clinical predictor score for difficult laryngeal exposure (DLE) during operative microlaryngoscopy.Study Design: Prospective cohort study in two academic institutions. Methods: We evaluated 319 patients before microlaryngoscopy for benign and malignant glottic diseases by a standardized preoperative assessment protocol (Laryngoscore) that included 11 parameters: interincisors gap (IIG), thyro-mental distance, upper jaw dental status, trismus, mandibular prognathism, macroglossia, micrognathia, degree of neck flexionextension, history of previous open-neck and/or radiotherapy, Mallampati's modified score, and body mass index (BMI). Each parameter was assessed to obtain a total score. Patients were divided into five classes according to the anterior commissure (AC) visualization: class 0, complete AC visualization with large-bore laryngoscopes in the Boyce-Jackson position; class I, as class 0 with external laryngeal counterpressure; class II, as class I in the flexion-flexion position; class III, as class II using small-bore laryngoscopes; and class IV, impossible AC visualization.Results: Class 0-I-II (good/acceptable laryngeal exposure) presented a median score < 6. This value was chosen as cutoff for distinguishing favorable versus difficult/impossible laryngeal exposures. When the Laryngoscore was < 6, good laryngeal exposure was observed in 94% of patients, whereas when 6, DLE was encountered in 40%. When considering a Laryngoscore of 9, 67% of patients had a DLE. At univariate analysis, IIG, upper jaw dental status, macroglossia, micrognathia, degree of neck flexion-extension, and BMI statistically impacted on DLE (P < 0.05).Conclusions: The Laryngoscore is a good predictor of DLE and assists in selecting the ideal candidates for operative microlaryngoscopy.

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Section: Resultsmentioning

confidence: 99%

Preoperative clinical predictors of difficult laryngeal exposure for microlaryngoscopy: The laryngoscore

Piazza¹,

Mangili²,

Bon³

et al. 2014

The Laryngoscope

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“…The pharyngeal structures were assessed with the patient's mouth widely opened as described by Mallarnpatti et al 7 The demographics such as age, sex, weight, and height were also recorded.…”

Section: Study Design For Patients In Groupmentioning

confidence: 99%

Lightwand intubation: II — Clinical trial of a new lightwand for tracheal intubation in patients with difficult airways

et al. 1995

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“…Competence should be assessed by completion of the ACLS examination, by a written examination covering issues not addressed by ACLS (including aspiration risk, recognition of compromised ventilation, hypoxemia-ventilation relationship, use of reversal agents, use of intravenous medications for hypotension and hypertension), by demonstration of techniques to open the airway on models, and by assessment of trainee's ability to prevent aspiration, assess airway risk, and manage airway compromise and other sedation complications promptly and appropriately (120,121).…”

Section: Assessment Of Competencementioning

confidence: 99%