NECK CIRCUMFERENCE TO THYROMENTAL DISTANCE RATIO IN COMPARISON WITH MALLAMPATI TEST: A STUDY TO PREDICT DIFFICULT INTUBATION
Dr. Samiksha Khanooja* and Dr. Madhusudan Upadya
Background: Difficult visualization of larynx, which might lead to difficult intubation is a major concern for anesthesiologists. By utilizing different predictors for difficult airway assessment, the airway can be secured without adverse consequences. Objectives: This study was performed to assess and compare the ratio of the neck circumference to thyromental distance (NC/TMD) with modified Mallampati score in predicting difficult intubation. Methods: The incidence of difficult tracheal intubation in 288 patients were studied. Difficult intubation was determined using the intubation difficulty scale (IDSâ‰¥5). The NC/TMD ratio was calculated and it was compared with the patientâ€™s modified Mallampati score to predict difficult intubation .Other factors like TMJ mobility, neck movement, presence of abnormal teeth etc were considered. Statistical analysis: The differences between the two predictors, modified Mallampati score and NC/TMD ratio were analysed using a Chi square test and Studentâ€™s unpaired t-test. Results: Difficult intubation was reported in 18 out of 288 patients (6.25%). Multivariate analysis revealed that the modified Mallampati score and NC/TMD can be used independently to predict difficult intubation, (IDSâ‰¥5). Among these two indices, NC/TMD showed the higher sensitivity and a negative predictive value. Conclusion: The NC/TMD is a reliable method for predicting difficult intubation like modified Mallampati score.
Keywords: Airway management, laryngoscopy, tracheal intubation, Mallampati, NC/TMD.
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