Background And Objectives: Difficulty intubating is a cause of mortality in anesthesiology and it can be related to obesity. The diagnosis of difficult intubation contributes for successful airways management. However, parameters that predict difficult airways are not well established. Mallampati classification, the interincisor gap, neck circumference, thyromental distance, and the presence of obstructive sleep apnea, are parameters that can indicate difficult intubation. Surgical treatment of obesity provides reduction in body mass index (BMI) with stabilization after about 2 years. The objective of the present study was to reevaluate the parameters described above and compare them with pre-surgical values.
Methods: The BMI, Mallampati classification, neck circumference, interincisor gap, thyromental distance, and the degree of obstructive sleep apnea in polysomnography were evaluated in 51 patients of both genders in the preoperative period. Two years after the surgery and reduction of the BMI to < 35 kg.m(-2), predictor factors of difficult airways were reevaluated by another anesthesiologist who knew the patients' BMI before surgery. Nine patients were excluded. The new reevaluation was performed, and for those who did not have another polysomnography the somnolence scale of Epiworth was applied.
Results: Forty-two patients were reevaluated. They showed a reduction in BMI and neck circumference, and an increase in both interincisor gap and thyromental distance. Only one patient showed a reduction in Mallampati scale, and only 4 patients performed polysomnography.
Conclusions: Reduction of the BMI allows for an increased interincisor gap, thyromental distance, and reduction in neck circumference. Mallampati classification remains the same.
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http://dx.doi.org/10.1016/S0034-7094(11)70004-6 | DOI Listing |
Background: Most of the studies on difficult intubation and laryngoscopy focused on American and European populations. However, Indians have distinct anthropometric characteristics compared to these populations. This study aims to determine the gender difference in inter-incisor distance (IID) cut-off marks to assess the ease of intubation in the Indian population.
View Article and Find Full Text PDFBMC Anesthesiol
December 2024
Department of Anesthesiology, Peking University Third Hospital, No. 49, North Garden Street, Haidian District, Beijing, 100191, China.
Backgrounds: Anticipating difficult laryngoscopy is crucial for preoperative assessment, especially for patients with cervical spondylosis. Radiological assessment has become essential for improving airway management safety. This research introduces novel radiological indicators from lateral cervical X-ray in the extended head position proposed to enhance the accuracy of predicting difficult laryngoscopy.
View Article and Find Full Text PDFHippokratia
January 2023
Otolaryngology Clinic, University Clinical Center in Niš, Niš.
Background: Head and neck surgery is considered high-risk for difficult intubation and accidental extubation. Laryngomicroscopy implies surgical manipulations at the level of the vocal cords. Also, this type of surgery demands a particular position for the patient during the whole surgical intervention.
View Article and Find Full Text PDFJ Korean Assoc Oral Maxillofac Surg
June 2024
Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, India.
Objectives: This prospective observational study aimed to assess the clinical outcomes of perioperative airway and ventilatory management in patients undergoing surgery for oral cavity cancer. The study described the frequencies and types of procedures for securing the airway and the duration and types of postoperative ventilatory support. We compared the findings with those of the TRACHY study.
View Article and Find Full Text PDFClin Exp Otorhinolaryngol
May 2024
Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.
Objectives: Considerable research has been focused on independent predictors of difficult laryngeal exposure (DLE) during suspension laryngoscopy. However, previous studies have yielded inconsistent results and conclusions. Consequently, we performed a meta-analysis of the existing literature with the aim of identifying significant parameters for a standardized preoperative DLE prediction system.
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