Using temporomandibular joint mobility to predict difficult tracheal intubation

The aim of this prospective study was to determine the reliability of temporomandibular joint (TMJ) mobility measurements for predicting difficult intubation. To evaluate the accuracy in predicting difficult intubation by TMJ mobility measurement, 762 patients requiring general anesthesia with trach...

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Bibliographic Details
Published in:Journal of anesthesia 2011-06, Vol.25 (3), p.457-461
Main Authors: Sahin, Sevtap Hekimoglu, Yılmaz, Ali, Gunday, Isıl, Kargı, Murat, Sut, Necdet, Taskınalp, Oguz, Ulucam, Enis
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Airway Management
Anesthesia, General
Anesthesiology
Anthropometry - methods
Critical Care Medicine
Emergency Medicine
Female
Humans
Incisor - anatomy & histology
Intensive
Intubation, Intratracheal - methods
Lip - anatomy & histology
Male
Medicine
Medicine & Public Health
Middle Aged
Mouth - anatomy & histology
Pain Medicine
Predictive Value of Tests
Preoperative Care
Reproducibility of Results
Short Communication
Temporomandibular Joint - anatomy & histology
Temporomandibular Joint - physiology
Young Adult
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Summary:The aim of this prospective study was to determine the reliability of temporomandibular joint (TMJ) mobility measurements for predicting difficult intubation. To evaluate the accuracy in predicting difficult intubation by TMJ mobility measurement, 762 patients requiring general anesthesia with tracheal intubation for elective surgery were enrolled in this prospective, observational, single-blind study. Maximum mouth opening, right–left jaw excursion, and degrees of protraction were determined with a digital inclinometer. Incisor gap was measured using a vernier caliper during full mouth opening. After induction of anesthesia using a standard protocol, the patient’s grade of laryngeal view by Cormack–Lehane classification was documented by an anesthesiologist. We found that the degrees of protraction and incisor gap in the easy intubation group were significantly higher than those in the difficult intubation group. The incisor gap was found to be more sensitive (88.37%) and more specific (95.71%) than protraction degrees (58.14% and 59.76%, respectively). The results revealed that measurements of the incisor gap and degrees of protraction may be useful routine screening tests for preoperative prediction of difficult intubation.
ISSN:0913-8668
1438-8359
DOI:10.1007/s00540-011-1126-3