RESUMEN
BACKGROUND: Application of upper lip catch test (ULCT) for airway evaluation in edentulous patients. METHODS: This research is an evaluation of a clinical diagnostic test in edentulous patients prior to operation. Five hundred eighty eight edentulous patients in a referral university hospital, between March 2008 and June 2011 scheduled for elective surgery under general anesthesia were enrolled. Those unable to open the mouth and those with pharyngo-laryngeal pathology were excluded. ULCT was assessed and compared with Cormack-Lehane grading as a gold standard for airway evaluation. RESULTS: A high negative predictive value of 99.4% was a notable finding for the ULCT. The results also showed a high specificity (89.4%), high sensitivity (75.0%) and a high accuracy (89.3%) in a comparatively higher range for the ULCT. CONCLUSION: The ULCT proved to be a useful predictor for airway assessment in edentulous patients in this setting. Further studies are needed to reconfirm its validity in other ethnic groups.
RESUMEN
The incidence of difficulty in tracheal intubation has been reported to range from 0.5 to 18% in patients undergoing surgery. We aimed to elucidate the role of upper lip bite test (ULBT) with other prevailing tests, hyomental/thyrosternal distances (HMD/TSD), and the mandible length (ML) and their possible correlation in predicting difficulty in intubation. After institutional approval and informed consent were obtained, 300 consecutive patients aged 20-60 years of ASA physical status I and II, scheduled for elective surgical procedures requiring tracheal intubation and meeting the inclusion criteria, were enrolled in this study. Each patient was evaluated regarding ULBT, HMD, TSD and ML. Laryngoscopy was assessed by an attending anaesthesiologist blinded to the measurements. The laryngoscopic result was graded according to Cormack and Lehane's Grading system. The negative predictive value (NPV) and positive predictive value (PPV) of ULBT were found to be 94 and 100%, respectively. These corresponding figures for TSD were 88.5 and 0%, respectively. Specificities for ULBT, HMD, ML and TSD were 100, 98.9, 98.9 and 98.1%, respectively. ULBT class and laryngoscopic grading showed the greatest agreement (kappa = 0.61, P < 0.001). An agreement between laryngoscopic grading and HMD and ML also existed (0.003 and <0.001, respectively), but was comparatively weaker. The high specificity, NPV, PPV and accuracy of ULBT as revealed in this study could be a good rationale for its application in the prediction of difficulty or easiness in intubation. ML > 9 cm and HMD > 3.5 cm were good predictors of negative difficult intubation.