Determination of the diagnostic value of the Modified Mallampati Score, Upper Lip Bite Test and Facial Angle in predicting difficult intubation: A prospective descriptive study

Mahmoodpoor, Ata; Soleimanpour, Hassan; Golzari, Samad Ej; Nejabatian, Arezoo; Pourlak, Tannaz; Amani, Masoumeh; Hajmohammadi, Saeed; Hosseinzadeh, Hamzeh; Esfanjani, Robab Mehdizadeh

doi:10.1016/j.jclinane.2016.12.010

Cited by 31 publications

(28 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar results were reported by Iohom et al [17]. Our results differed from some studies that have reported a higher sensitivity [34,35,36], and from those of Hashim et al [27], who evaluated ve airway tests in 60 patients of both genders, and found a 23% sensitivity, 68% speci city, 58% accuracy, and 16% PPV of the Mallampati test, which were smaller in comparison to our study. The wide variations in the reported sensitivities and speci cities of the MMT may be due to the considerable interobserver variability found during this assessment, which related to the performance of the test with or without phonation, patient cooperation, or patient position [16,37].…”

Section: Discussioncontrasting

confidence: 55%

Evaluation of different airway tests to determine difficult intubation in apparently normal adult patients: A prospective observational study

El-Radaideh

Dheeb

Shboul

et al. 2020

Preprint

View full text Add to dashboard Cite

Background It is important to perform preoperative airway tests for prediction of difficult intubations because inadequate maintenance of a patient’s airway is still the major cause of anesthesia-related morbidity and mortality. Methods We conducted this study to determine which airway test, or combination of airway tests, was most clinically useful. One hundred sixty adult patients underwent preoperative assessments of the mandible protrusion test (MPT), thyromental (TMD) and sternomental (SMD) distances, inter-incisor gap (IIG), and the modified Mallampati tests with tongue protrusion (MMT-TP) and without tongue protrusion (MMT-NTP). Grade C on the MPT, TMD ≤ 6 cm, SMD ≤ 12 cm, and MMT grades III and IV were considered to be predictors of difficult tracheal intubations. A modified Cormack-Lehane grading (MCLG) of laryngoscopic views with backward, upward, and right-sided pressure on the thyroid and cricoid cartilages (BURP) maneuver was also documented, with grades 2B, 3, and 4 considered to be difficult airways for intubation. Results Fifteen patients (9.4%) were classified as MCLG 2B, 3, and 4, with age significantly associated with the MCLG grade (P = 0.028). The sensitivity and Youden's index of MMT-TP were found to be the lowest (40% and 0.29, respectively). The MPT was the most accurate and specific test (90.63% and 95.17%, respectively), with the highest PPV (50%), Youden's index (0.42), and area under the curve (AUC) (0.781). Bivariant analysis of MPT and the t-test of the mean TMDs and SMDs revealed significant associations between these airway tests and the difficulty of intubation (P values: < 0.001, 0.02, < 0.01, respectively). Conclusion The MPT, with its highest accuracy, specificity, positive predictive value, and good sensitivity may be used as a routine screening test for preoperative prediction of difficult tracheal intubations.

show abstract

Section: Discussioncontrasting

confidence: 55%

Evaluation of different airway tests to determine difficult intubation in apparently normal adult patients: A prospective observational study

El-Radaideh

Dheeb

Shboul

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Similar results were reported by Iohom et al [17]. Our results differed from some studies that have reported a higher sensitivity [34,35,36], and from those of Hashim et al [27], who evaluated ve airway tests in 60 patients of both genders, and found a 23% sensitivity, 68% speci city, 58% accuracy, and 16% PPV of the Mallampati test, which were smaller in comparison to our study. The wide variations in the reported sensitivities and speci cities of the MMT may be due to the considerable inter-observer variability found during this assessment, which related to the performance of the test with or without phonation, patient cooperation, or patient position [16,37].…”

Section: Discussionsupporting

confidence: 53%

Evaluation of different airway tests to determine difficult intubation in apparently normal adult patients undergoing surgical procedures.

El-Radaideh

Dheeb

Shboul

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Inadequate maintenance of a patient's airway represents a major cause of anesthesia-related morbidity and mortality. This study was designed to evaluate common preoperative clinical tests to determine the risk of difficult endotracheal intubation in apparent "normal" adult patients undergoing surgical procedures.Methods: A prospective observational cohort study was performed on 160 consecutive adult patients undergoing surgical procedures at an academic medical center in Jordan from 20 May 2019 until 11 February 2020. Preoperative assessment of airway risk stratification was performed by the following clinical tests: the mandible protrusion test (MPT), thyromental (TMD) and sternomental (SMD) distances, inter-incisor gap (IIG), and the modified Mallampati tests with tongue protrusion (MMT-TP) and without tongue protrusion (MMT-NTP). Grade C on the MPT, TMD ≤ 6 cm, SMD ≤ 12 cm, and MMT grades III and IV were considered to be predictors of difficult endotracheal intubations. A modified Cormack-Lehane grading (MCLG) of laryngoscopic views with backward, upward, and right-sided pressure on the thyroid and cricoid cartilages (BURP) maneuver was also documented, with grades 2B, 3, and 4 considered to be difficult airways for intubation. Results: Fifteen patients (9.4%) were classified as MCLG 2B, 3, and 4, with age significantly associated with the MCLG grade (P = 0.028). The sensitivity and Youden's index of MMT-TP were found to be the lowest (40% and 0.29, respectively). The MPT was the most accurate and specific test (90.63% and 95.17%, respectively), with the highest PPV (50%), Youden's index (0.42), and area under the curve (AUC) (0.781). Bivariant analysis of MPT and the t-test of the mean TMDs and SMDs revealed significant associations between these airway tests and the difficulty of intubation (P values: < 0.001, 0.02, < 0.01, respectively). Conclusion: The MPT, with its highest accuracy, specificity, positive predictive value, and good sensitivity may be used as a routine screening test for preoperative prediction of difficult endotracheal intubations.

show abstract

“…Airways management is one of the challenging issues in terms of critical patients. A patient would be detoriate or harmed if he/she becomes hypoxic or being inadequately ventilated ( 1 , 5 , 10 - 12 ). BMV is an urgent and necessary method to control the airway and ventilate the patient before the medical staffs prepare a secure one.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Three Techniques on Facility of Bag-Mask Ventilation: Thenar Eminence, E-O and E-C

et al. 2018

Self Cite

View full text Add to dashboard Cite

BackgroundRapid and secure management of airway is an important lifesaving intervention in critically ill patients at emergency wards. Training undergraduate students about airway management must be regarded as a priority in their education period. The aim of the present study was to compare the quality of three ventilation techniques with a bag and mask among two groups of undergraduate students (Novices) and senior group (Experienced) in Tabriz University of Medical Sciences.MethodsThis study was a mannequin type research that was carried out in the faculty of medicine, Tabriz University of Medical Sciences. The study population consisted of two elementary groups (Novices) and senior group (Experienced). The number of participants included 100 individuals. Ventilation quality by bag and mask in two groups was recorded based on the rise of lungs and two reviewers' opinions who gave a score from 1 as weak to 4 as excellent using three techniques of E-C, E-O, and Thenar Eminence. In the E-C technique, index fingers and thumbs form two “C”s facing each other while the remaining fingers lift the mandible and form two “E”s. In E-O techniques, the web between thumb and index finger is used to form a circle around the neck of the mask while other fingers perform a chin lift. In thenar eminence techniques, the thenar eminence and thumb are placed on the top of the mask while other fingers perform jaw thrust.ResultsIn our study, 27% of undergraduate participants and 59% of seniors were male and the others were female. The mean of age of elementary and seniors were 24 and 33.5, respectively (P < 0.05). E-O technique was well done by the novices group.ConclusionsBased on our results, it was concluded that the elementary group performed E-O bag and mask ventilation technique appropriately. Therefore, it can be suggested that training of this technique will be placed in educational curriculum of undergraduate students.

show abstract

Determination of the diagnostic value of the Modified Mallampati Score, Upper Lip Bite Test and Facial Angle in predicting difficult intubation: A prospective descriptive study

Cited by 31 publications

References 16 publications

Evaluation of different airway tests to determine difficult intubation in apparently normal adult patients: A prospective observational study

Evaluation of different airway tests to determine difficult intubation in apparently normal adult patients: A prospective observational study

Evaluation of different airway tests to determine difficult intubation in apparently normal adult patients undergoing surgical procedures.

Comparison of Three Techniques on Facility of Bag-Mask Ventilation: Thenar Eminence, E-O and E-C

Contact Info

Product

Resources

About