title: Upper lip bite test in a patient with McCune Albright syndrome with acromegaly.
abstract: We report a patient with McCune Albright syndrome with acromegaly and features predictive of difficult airway except a class I upper lip bite (ULB) test. Our patient, a 33-year-old woman, had a history of polyostotic fibrous dysplasia. Tracheal intubation was performed under general anaesthesia. Although we did not find any difficulty in visualizing the glottis by direct laryngoscopy; our patient had multiple poor predictive signs of airway assessment including a Mallampati grade III, restricted neck movement and macroglossia. Our report suggests that the ULB test in people with acromegaly may act as an indicator of easy intubation in spite of other poor predictive signs. However, this finding needs further corroboration by a large study to evaluate the role of the ULB test in people with acromegaly.
authors.affiliation: Department of Neuroanesthesiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Chandrashish
authors.initials: C
authors.lastname: Chakravarty
authors.forename: Naveen
authors.initials: N
authors.lastname: Yadav
authors.forename: Zulfiqar
authors.initials: Z
authors.lastname: Ali
authors.forename: Hemanshu
authors.initials: H
authors.lastname: Prabhakar
mesh_terms: D000172:Acromegaly / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D000328:Adult; D000402:Airway Obstruction / Q000175:diagnosis* / Q000503:physiopathology; D004185:Disability Evaluation; D005147:Facial Bones / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005359:Fibrous Dysplasia, Polyostotic / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D019416:Head Movements / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods; D007574:Jaw Relation Record / Q000379:methods*; D007828:Laryngoscopy; D008260:Macroglossia / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D009055:Mouth / Q000473:pathology / Q000503:physiopathology; D009333:Neck / Q000473:pathology / Q000503:physiopathology; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology; D012720:Severity of Illness Index; D012886:Skull / Q000473:pathology* / Q000503:physiopathology