Lateral neck radiography for prediction of difficult orotracheal intubation. Academic Article uri icon

Overview

abstract

  • BACKGROUND AND OBJECTIVES: Failed endotracheal intubation is a principal cause of morbidity and mortality in anesthetized patients. The aim of this study was to investigate the efficiency of lateral neck radiography in predicting difficult intubation. METHODS: In a prospective triple-blind study, 100 patients (aged 18-89 yr), scheduled for elective surgery were randomly selected. Lateral neck X-ray was obtained from each of the patients before operation. Several angles and parameters on the X-ray were proposed to illustrate a relationship with easy or difficult intubation. A radiologist recorded these angles before the operation. An anaesthesiologist also determined the Mallampati score preoperation. At the time of intubation, two other anesthesiologists performed a laryngoscopy and, according to established criteria, identified the patients as easy or difficult intubation. The results were then compared with each other. RESULTS: Fifteen patients were identified as having difficult intubation (laryngoscopy Grades III and IV). Sensitivity and specificity of the Mallampati Class test were 26% and 100%, respectively. The sensitivity and specificity of the lateral neck X-ray for three measured angles were 100%. The positive and negative predictive values (NPVs) for those angles were 100% and for Mallampati classification were 100% and 80%, respectively. CONCLUSIONS: Compared to the Mallampati Class test, our method of analyzing the lateral X-ray, although not as easy and universally applicable as Mallampati Class test, proved to be a suitable method for predicting difficult intubation.

publication date

  • September 1, 2005

Research

keywords

  • Intubation, Intratracheal
  • Neck
  • Trachea

Identity

Scopus Document Identifier

  • 24744464568

Digital Object Identifier (DOI)

  • 10.1017/s0265021505001146

PubMed ID

  • 16163916

Additional Document Info

volume

  • 22

issue

  • 9