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The relevance of clinical and radiological measurements in predicting difficulties in fibreoptic orotracheal intubation in adults
Author(s) -
Randell T.,
Hakala P.,
Kyttä J.,
Kinnunen J.
Publication year - 1998
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.1998.00612.x
Subject(s) - medicine , epiglottis , intubation , orotracheal intubation , radiological weapon , laryngoscopy , tongue , tracheal tube , glottis , airway , anesthesia , surgery , larynx , pathology
Resistance to the passage of the tracheal tube has been reported to occur in up to 36% of patients subjected to orotracheal fibreoptic intubation. In this prospective study we assessed five radiological measurements of the upper airway in an attempt to find anatomical causes of obstruction to passage of the tube. Forty‐nine patients undergoing fibreoptic orotracheal intubation under general anaesthesia were studied. Pre‐operatively, the Mallampati grade and the thyromental distance were assessed. The plain films, CT scans or MR images of the cervical spine were used for measurement of the position of the vocal cords, the length of the epiglottis and the size of the tongue. The resistance to the passage of the tube was graded as none, mild, moderate or severe. The length of the epiglottis and the size of the tongue, but not the position of the vocal cords, had positive correlations with the severity of impingement. The pre‐operative bedside tests did not correlate with difficulties in fibreoptic intubation.