title: Using temporomandibular joint mobility to predict difficult tracheal intubation.
abstract: 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.
authors: Department of Anaesthesiology and Reanimation, Trakya University Medical Faculty, 22030, Edirne, Turkey. sevtaphekimoglu@mynet.com
authors: Sevtap Hekimoglu
authors: SH
authors: Sahin
authors: Ali
authors: A
authors: Yilmaz
authors: Isil
authors: I
authors: Gunday
authors: Murat
authors: M
authors: Kargi
authors: Necdet
authors: N
authors: Sut
authors: Oguz
authors: O
authors: Taskinalp
authors: Enis
authors: E
authors: Ulucam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058109:Airway Management; D000768:Anesthesia, General; D000886:Anthropometry / Q000379:methods; D005260:Female; D006801:Humans; D007180:Incisor / Q000033:anatomy & histology; D007442:Intubation, Intratracheal / Q000379:methods*; D008046:Lip / Q000033:anatomy & histology; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000033:anatomy & histology; D011237:Predictive Value of Tests; D011300:Preoperative Care; D015203:Reproducibility of Results; D013704:Temporomandibular Joint / Q000033:anatomy & histology* / Q000502:physiology*; D055815:Young Adult