Relevance of radiological and clinical measurements in predicting difficult intubation using light wand (Surch-lite™) in adult patients

Joungmin Kim, Kyong Shil Im, Jae Myeong Lee, Jaehun Ro, Kyung Yeon Yoo, Jong Bun Kim, Joungmin Kim, Kyong Shil Im, Jae Myeong Lee, Jaehun Ro, Kyung Yeon Yoo, Jong Bun Kim

Abstract

Objective: To determine the correlation between anatomical features of the upper airway (evaluated via computed tomography imaging) and the ease of light wand-assisted endotracheal intubation in patients undergoing ear, nose and throat surgery under general anaesthesia.

Methods: Mallampati class, laryngoscopic grade, thyromental distance, neck circumference, body mass index, mouth opening and upper lip bite class were assessed. Epiglottis length and angle, tongue size and narrowest pharyngeal distance were determined using computed tomography imaging. Intubation success rate, time to successful intubation (intubating time) and postoperative throat symptoms were documented.

Results: Of 152 patients, 148 (97.4%) were successfully intubated on the first attempt (mean intubating time 11.5 ± 6.7 s). Intubating time was positively correlated with laryngoscopic grade and body mass index in both male and female patients, and Mallampati class and neck circumference in male patients. Epiglottis length was positively correlated with intubating time.

Conclusions: Ease of intubation was influenced by epiglottis length. Radiological evaluation may be useful for preoperative assessment of patients undergoing endotracheal intubation with light wand.

Keywords: Epiglottis; Intubation; Light wand; Tongue.

© The Author(s) 2015.

Figures

Figure 1.
Figure 1.
Sagittal computed tomography image of the paranasal sinus indicating the measurements used in the study. 1, tongue length; 2, tongue height; 3, epiglottis length; 4, pharyngeal gap; 5, epiglottic angle (angle between a perpendicular line subtended from the vallecula and the line subtended from the posterior wall of the epiglottis)

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