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Introduction: The present study was carried out to evaluate the efficacy of neck circumference to thyromental distance (NC/TM) ratio to predict difficult intubation in obese patients on background of routinely practiced Modified Mallampati Classification (MMC). Materials and Methods: Total 60 obese patients (BMI ≥ 30 kg/m2) of either sex were studied in the present study. Difficult intubation was predicted by using both NC/TM ratio and modified Mallampati score. Intubation difficulties were noted using Intubation Difficulty Scale (IDS) while performing laryngoscopy and intubation. Results: NC/TM ratio showed higher sensitivity (92.31%), higher negative predictive value (93.75%) and higher area under curve (AUC=0.73) on the ROC curve than MMC score and also found that NC/TM ratio was statistically significant independent risk factor of difficult intubation (p value <0.029, odds ratio4.52). Conclusion: NC/TM ratio can be considered as reliable and better bedside screening test for predicting intubation difficulties in obese

Neck circumference to thyromental distance ratio: Is a reliable predictor of difficult intubation in obese patients?