Tongue movements and predict difficult intubation

Abstract

We aimed to test our hypothesis that the tongue movement test could estimate for difficult tracheal intubation.288 patients undergoing surgery with general anesthesia were enrolled in this study. To define the tongue movements, horizontal and vertical lines are used. Horizontal lines passing through the mid points of the distance between subnasale to stomion and stomion to mentum, and vertical lines passing through the right and left infraorbitale points were constituted on each patient. Patients were asked to protrude the tip of the tongue upward, downward and laterally (left-right) in anatomical neutral position. There was no significant difference in demographical data. The patients who cannot reach horizontal line in upward levels in difficult intubation group were significantly higher rates than easy intubation group (p<0.001). The patients who cannot reach horizontal line in upward, OR=958.3 (95% CI:152.8-6011.2) times increased to difficult intubation. The protruding tongue maximally and upward test is a simple test for predicting difficult intubation.