Comparison of the angle deviation of the nose line to the mentum and Mallampati test in predicting the difficult airway before anesthesia.

Abstract

A high percentage of dangerous events in anesthesia occur due to airway problems, and proper airway management is always one of the key points during anesthesia. Airway management in critically ill patients is one of the most stressful situations for primary care physicians and even for anesthesiologists. The aim of this study was to evaluate the anatomical features of patients' airways, including the angle of deviation of the nasal line from the nasal to the mentum (NMLD), and perform a Mallampati test. This cross-sectional study was performed on all patients admitted to Shohada Hospital in Tabriz, Iran, who were candidates for elective surgery for 1 year and 6 months, and underwent endotracheal intubation. Based on laryngeal observation, patients were classified into four groups. Then, all data related to individuals including type of surgery, age, sex, weight, height, body mass index (BMI), and nasal mentum line deviation (NMLD) were recorded. Then, all the collected data were analyzed using SPSS software version 19. A total of 85 patients from 17 to 67 years with a mean age of 37.64 ± 12.89 were studied. There was a statistically significant relationship between laryngoscopy difficulty and Mallampati score (P = 0.001). The findings showed a statistically significant relationship between laryngoscopy difficulty and the mean NMLD (P = 0.01). A Mallampati of 85% indicates laryngoscopy difficulty. Also, NMLD can predict laryngoscopy difficulty by up to 66%. The present study demonstrated that both the Mallampati score variable and NMLD are related to the difficult airway problem. Furthermore, the Mallampati score has a higher predictive value for difficult intubation than the NMLD.