Evaluation of the upper lip bite test in predicting difficult laryngoscopy.
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.
Myneni
Neelima
N
Albany Medical College, Albany, NY 12208, USA.
O'Leary
Anthony M
AM
Sandison
Michael
M
Roberts
Kevin
K
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