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Thyromental distance measurement – fingers don’t rule
Author(s) -
Baker P. A.,
Depuydt A.,
Thompson J. M. D.
Publication year - 2009
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2009.05985.x
Subject(s) - medicine , ruler , orthodontics , quantum mechanics , physics
Summary Thyromental distance (TMD) measurement is commonly used to predict difficult intubation. We surveyed anaesthetists to determine how this test was being performed. Comparative accuracy of ruler measurement and other forms of measurement were also assessed in a meta‐analysis of published literature. Of respondents, 72% used fingers for TMD measurement and also considered three finger widths the minimum acceptable TMD. In terms of distance, the minimum acceptable TMD was felt to be 6.5 cm by 55% of respondents. However, the actual width of three fingers was (range) 4.6–7.0 cm (mean 5.9 cm), with significant differences between genders and between proximal and distal interphalangeal joints. The meta‐analysis showed ruler measurement increased test sensitivity (48% (95% CI 43–53) vs 16% (95% CI 14–19) without a ruler), when predicting difficult intubation.