title: The palm print as a sensitive predictor of difficult laryngoscopy in diabetics: a comparison with other airway evaluation indices.
abstract: OBJECTIVE
  To evaluate the ink impression made by the palm of the dominant hand as a screening tool for difficult laryngoscopy in diabetic patients.
  
  
  METHODS
  In this prospective study, airway of 50 adult diabetic patients, undergoing elective surgery under general anaesthesia, was assessed preoperatively using the common clinical indices such as Modified Mallampati test, thyromental distance, degree of head extension and a specific index- the palm print test. Following induction of anaesthesia and neuromuscular relaxation, laryngoscopy was performed and the laryngoscopic view scored. The sensitivity, specificity and positive predictive value of each airway evaluation index were calculated.
  
  
  RESULTS
  The incidence of difficult laryngoscopy was 16%. The palm print test had the highest sensitivity (75%) of all the indices. The thyromental distance less than six cm had the highest specificity (95.2%) but was least sensitive (25%). 87% of patients with difficult laryngoscopy had two or more indices abnormal.
  
  
  CONCLUSIONS
  Though the palm print test was the most sensitive index of the four indices studied, a better prediction of difficult laryngoscopy can be achieved by evaluating all the four airway indices preoperatively.
authors.affiliation: Department of Anaesthesiology, Seth G. S. Medical College and K. E. M. Hospital, Parel, Mumbai - 400 012, India.
authors.forename: V
authors.initials: V
authors.lastname: Vani
authors.forename: S K
authors.initials: SK
authors.lastname: Kamath
authors.forename: L D
authors.initials: LD
authors.lastname: Naik
mesh_terms: D003878:Dermatoglyphics; D048909:Diabetes Complications; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D007592:Joint Diseases / Q000209:etiology; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity