prediction of difficult airway in patient undergoing elective surgery a comparative study of sternomental distance and mallampati score

Abstract:

Background:

Difficult or failed tracheal intubation has been identified as one of the most important causes of death or permanent brain damage during anesthesia. The present study is an attempt to compare modified Mallampati score and stern omental distance for predicting difficult intubation in adult patients. There is an impelling need for accurate tests to predict difficult intubation, as failure to achieve endotracheal intubation causes significant morbidity and mortality in anesthetic practice.

Objective:

The objective of this study was to systematically determine the diagnostic accuracy of bedside tests for predicting difficult intubation in patients with no airway pathology.Currently available screening tests for difficult intubation have only poor to moderate discriminative power when used alone. Combinations of tests add some incremental diagnostic value in comparison to the value of each test alone. The clinical value of bedside screening tests for predicting difficult intubation remains limited.

To find the best predicting test for difficult airway.

Methods and Material:

This study is approved by the research and ethical committee of northwest institute of health sciences Peshawar. The data is collected by Meta-analysis of various published articles. All those points which are linked to our studies or have some importance to our studies have been gathered from these published articles. The reviewed articles were obtained from the following website:PubMed, Research Gate, Google Scholar, Morgan and Mikhail’s clinical Anesthesiology International Journal of Research in Medical sciences

Results:

Screening tests included the Mallampati oropharyngeal classification, thyromental distance, sternomental distance, mouth opening, and Wilson risk score. Each test yielded poor to moderate sensitivity (20-62%) and moderate to fair specificity (82-97%). The most useful bedside test for prediction was found to be a combination of the Mallampati classification and thyromental distance (positive likelihood ratio, 9.9; 95% confidence interval, 3.1-31.9).

Conclusion;

Efficacy of combining MMT and SMD is also significantly higher than any single test. Hence all the two tests should be ideally used in assessing the airway in adult patients for surgery under GA.