Barsha Sen1 , Manasij Mitra2 , Kanak Kundu3 , Maitraye Basu4
BACKGROUND Unanticipated difficult intubation is one of the most dreaded complications in anaesthesiology practice. The predictive reliability of the various tests currently available for predicting difficult airway is unclear. The purpose of this study was to assess the diagnostic accuracy of Modified Mallampati Test (MMP) and Thyromental Distance Test (TMD) individually and also in combination in predicting difficult laryngoscopy, by correlating these tests with Cormack-Lehane’s grading. METHODS This observational study was conducted among 500 patients over a period of 2.5 years from April 2017 - September 2019, in MGM Medical College and LSK Hospital, Kishanganj, Bihar, India. 500 adult patients of either sex, having American Society of Anaesthesiology (ASA) status I, II and scheduled for elective surgery under general anaesthesia with endotracheal intubation were selected for this study. RESULTS While assessing the airway assessment data, MMP / TMD had the highest (92.31%) and TMD had the lowest (65.0%) sensitivity. For specificity TMD had the highest specificity (99.3%) among all the tests, and MMP had the lowest specificity (89.14%) as per our study. Diagnostic accuracy was highest in TMD (97.0%), closely followed by MMP / TMD (90.80%) and MMP (87.3%) respectively. PPV was highest in TMD (100%) and lowest in MMP (57.0%), and NPV was highest in MMP / TMD (97.81%) and lowest in TMD (72.81%). CONCLUSIONS We conclude that, MMP / TMD is the more preferred predicator than the individual tests MMP and TMD for assessing and predicting difficult airway.
