Comparison of acromio axillary sternal notch index, thyromental height test, and modified mallampati test in preanesthetic prediction of difficult laryngoscopy

Elsevier

Available online 17 September 2022

Trends in Anaesthesia and Critical CareHighlights•

Acromio axillary sternal notch index is an ideal standalone preanesthetic predictor of difficult laryngoscopy.

Thyromental height test is a more specific indicator.

Modified Mallampati test owing to its ease of performance can be used but is not an ideal predictor.

AbstractIntroduction

The unanticipated difficult airway is a challenge to anaesthesiologists owing to the undesirable respiratory and cardiac outcomes and other related complications. Three different predictors have been used, which include a Modified Mallampati Test, Thyromental Height Test, and the newly proposed Acromio Axillary Sternal Notch Index. In this study, we aim to compare the validity of the Acromio Axillary Sternal Notch Index, Thyromental Height Test and the Modified Mallampati Test as preanesthetic predictors of difficult laryngoscopy.

Methodology

Patient's demographics were assessed and physical examination were carried out based on the predictive tools Modified Mallampati Test, Thyromental Height Test, Acromio Axillary Sternal Notch Index.

Results

The majority of the patients in this study were <60yrs of age. Out of 358 participants, 57.5% were females and 42.5% were males. Our study shows an incidence of 24.6% for difficult laryngoscopy. The study reveals that the Thyromental Height Test examination had high specificity compared to the Modified Mallampati Test examination, but the ability to predict true difficult laryngoscopy was less when compared to Modified Mallampati Test. The new predictor, Acromio Axillary Sternal Notch Index, had high sensitivity and high positive predictive compared to the other two predictors, Modified Mallampati Test and Thyromental Height Test.

Conclusion

The study concludes that the Acromio Axillary Sternal Notch Index is an ideal standalone preanesthetic predictor of difficult laryngoscopy based on its high sensitivity and high positive predictive value.

Keywords

Laryngoscopy

Airway management

Airway obstruction

An

esthesiology

Preoperative procedure

Physical examination

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© 2022 Published by Elsevier Ltd.

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