Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Difficult airway management is a critical challenge in anesthesiology. Accurate preoperative assessment is essential to predict and manage difficult intubations. This study evaluates the validity of widely accepted clinical and radiological screening tests to predict difficult airway in surgical patients. To compare the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of clinical and radiological parameters in predicting difficult intubation. A prospective observational study was conducted on 300 patients aged 15‐75 years undergoing surgery under general anesthesia with endotracheal intubation. Clinical predictors included the modified Mallampati classification, inter‐incisor gap, thyromental distance, sternomental distance and Wilson risk sum score. Radiological parameters included atlanto‐occipital distance, effective mandibular length, anterior and posterior mandibular depths and C2 spine depth. Difficult intubation was defined as Cormack‐Lehane grades III or IV during laryngoscope. Sensitivity, specificity, PPV and NPV of each parameter were analyzed. Difficult intubation was observed in 38 patients (12.7%). Among clinical predictors, modified Mallampati classification had the highest sensitivity (100%) and NPV (100%), while thyromental distance demonstrated the highest specificity (99.4%) and PPV (97.43%). Radiological predictors showed limited sensitivity, with atlanto‐occipital distance achieving the highest sensitivity (97.43%) and NPV (99.37%). Effective and posterior mandibular depths, as well as C2 spine depth, exhibited lower predictive values. Clinical parameters, particularly modified Mallampati classification, thyro mental distance and sterno mental distance, are more reliable than radiological measurements in predicting difficult airway. Preoperative airway assessment should prioritize clinical screening tools for effective airway management.
How to cite this article:
Padma Amar Vishal, Rudraraju Sri Soumya and V. Thoyaja Devi. Evaluation of Preoperative Screening Tests for Predicting Difficult Airway in Surgical Patients.
DOI: https://doi.org/10.36478/10.36478/makrjms.2025.1.490.494
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2025.1.490.494