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A clinical sign to predict difficult tracheal intubation; a prospective study

Abstract

It has been suggested that the size of the base of the tongue is an important factor determining the degree of difficulty of direct laryngoscopy. A relatively simple grading system which involves preoperative ability to visualize the faucial pillars, soft palate and base of uvula was designed as a means of predicting the degree of difficulty in laryngeal exposure. The system was evaluated in 210 patients. The degree of difficulty in visualizing these three structures was an accurate predictor of difficulty with direct laryngoscopy (p < 0,001).

Résumé

Il a été suggéré que la grosseur de la base de la langue est un facteur important dans la détermination du degré de difficulté de la laryngoscopie directe. Un système relativement simple de classification impliquant la capacité pré-opératoire de visualiser les piliers du voile du palais, le voile du palais et la base de la luette a été conçu afin de prédire le degré de la difficulté d’ exposition du larynx. Ce système a été évalué chez 210 patients. On a trouvé que le degré de difficulté encourue lors de la visualisation de ces trois structures était un moyen précis pour prédire la difficulté de la laryngoscopie directe (p < 0.001).

References

  1. Mallampati SR. Clinical sign to predict difficult tracheal intubation (hypothesis). Can Anaesth Soc J 1983; 30:316–7.

    PubMed  CAS  Article  Google Scholar 

  2. Cass NM, James NR, Lines V. Difficult direct laryn- goscopy complicating intubation for anaesthesia. Br Med J 1956; 1:488–9.

    PubMed  CAS  Google Scholar 

  3. White A, Kander PL. Anatomical factors in difficult direct laryngoscopy. Br J Anaesth 1975: 47:468–74.

    PubMed  Article  CAS  Google Scholar 

  4. Nichol HC, Zuck D. Difficult laryngoscopy - the“ anterior” larynx and the atlanto-occipital gap. Br J Anaesth 1983; 55:141–3.

    PubMed  Article  CAS  Google Scholar 

  5. Bannister FB, MacBeth RG. Direct laryngoscopy and intubation. Lancet 1944; 2:651–4.

    Article  Google Scholar 

  6. Gillespie NA. Endotracheal anesthesia. 2nd edition. Madison: University of Wisconsin Press, 1950.

    Google Scholar 

  7. Salem MR, Mathrubhutham M, Bennet EJ. Difficult intubation. N Engl J Med 1976; 295:879–81.

    PubMed  CAS  Article  Google Scholar 

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Mallampati, S.R., Gatt, S.P., Gugino, L.D. et al. A clinical sign to predict difficult tracheal intubation; a prospective study. Can Anaesth Soc J 32, 429–434 (1985). https://doi.org/10.1007/BF03011357

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  • DOI: https://doi.org/10.1007/BF03011357

Key words

  • intubation
  • endotracheal: complications
  • difficult intubation
  • anaesthetic techniques
  • laryngoscopy