title: Evaluation of the upper lip bite test in predicting difficult laryngoscopy.
abstract: OBJECTIVE
  To evaluate the accuracy of the upper lip bite test (ULBT) in predicting difficult laryngoscopy.
  
  
  METHODS
  Prospective, observational outcome study.
  
  
  METHODS
  Operating room of a large tertiary-care academic medical center.
  
  
  METHODS
  6,882 consecutive adult, ASA physical status I, II, III, IV, and V patients, scheduled for procedures in all surgical specialties.
  
  
  METHODS
  Upper lip bite test class was determined for all patients preoperatively.
  
  
  METHODS
  The Cormack & Lehane grade of laryngeal view was determined at endotracheal intubation.
  
  
  RESULTS
  Only 171 patients had ULBT class III, predicting a difficult laryngoscopy, while 173 patients presented with a Cormack & Lehane grade of 3 or 4. Of the 173, 14 patients had a previous ULBT class of III. Sensitivity and positive predictive value of the ULBT were 8.1% and 8.2%, respectively.
  
  
  CONCLUSIONS
  The ULBT is a poor predictor of difficult laryngoscopy when used as the single bedside screening test in a North American patient population. Its use cannot be recommended.
authors.affiliation: Albany Medical College, Albany, NY 12208, USA.
authors.forename: Neelima
authors.initials: N
authors.lastname: Myneni
authors.forename: Anthony M
authors.initials: AM
authors.lastname: O'Leary
authors.forename: Michael
authors.initials: M
authors.lastname: Sandison
authors.forename: Kevin
authors.initials: K
authors.lastname: Roberts
mesh_terms: D000402:Airway Obstruction / Q000175:diagnosis*; D006801:Humans; D007442:Intubation, Intratracheal; D007828:Laryngoscopy / Q000379:methods*; D008046:Lip; D008499:Medical Records / Q000592:standards*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D016896:Treatment Outcome