Comparison of Upper Lip Bite Test and Thyromental Distance with Other Airway (Malampatti and Inter Incisor Distance) Assessment Tests for Predicting Difficult Endotracheal Intubation

Muhammad Tayyab Saeed; Ali Rao; Muhammad Nasir  Saeed; Tasneem Alam; Azmat  Riaz; Hira Ahmad

doi:10.51253/pafmj.v74i5.8112

Authors

Muhammad Tayyab Saeed Department of Anesthesia, Combined Military Hospital, Quetta/National University of Medical Sciences (NUMS) Pakistan
Ali Rao Department of Anesthesia, Combined Military Hospital, Multan/National University of Medical Sciences (NUMS) Pakistan
Muhammad Nasir Saeed Department of Anesthesia, Allied Hospital, Faisalabad Pakistan
Tasneem Alam Department of Anesthesia, Combined Military Hospital, Quetta/National University of Medical Sciences (NUMS) Pakistan
Azmat Riaz Department of Anesthesia, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Hira Ahmad Department of Anesthesia, World Meteorological Organization, THQ Hospital, Gujjar Khan, Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i5.8112

Keywords:

Endotracheal intubation, Mallampati grading, Thyromental distance, Upper lip bite test

Abstract

Objective: To study the ability of upper lip bite test and thyromental distance to predict difficult endotracheal intubation when compared to standard assessment tests such as Mallampati and inter incisor distance.

Study Design: Cross-sectional validation study.

Place and Duration of Study: Department of Anesthesiology, Pak-Emirates Military Hospital, Rawalpindi, Pakistan, Sep 2020 to Mar 2021.

Methodology: We studied a total of 50 patients who reported for the administration of general anesthesia. All patients underwent evaluation with modified Mallampati test, upper lip bite test and thyromental distance test. All participants underwent subsequent intubation according to a standard protocol. The researcher documented difficult intubations.

Results: We found the upper lip bite test to have a sensitivity of 75.7%, a specificity of 84.2%, and a diagnostic accuracy of 78.6%. Thyromental distance had a sensitivity, specificity, and diagnostic accuracy of 51.4%, 78.9% and 60.7%, respectively while the modified Mallampati had a sensitivity of 64.9%, 89.5%, specificity and a diagnostic accuracy of 73.2%.

Conclusion: Upper lip bite test is a useful bedside assessment tool with which to predict the probability of a difficult endotracheal intubation. Height to thyromental distance ratio test is also acceptable for rapid assessment.

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