title: [Predictive value of preoperative tests in estimating difficult intubation in patients who underwent direct laryngoscopy in ear, nose, and throat surgery].
abstract: OBJECTIVE
  Predictive value of preoperative tests in estimating difficult intubation may differ in the laryngeal pathologies. Patients who had undergone direct laryngoscopy (DL) were reviewed, and predictive value of preoperative tests in estimating difficult intubation was investigated.
  
  
  METHODS
  Preoperative, and intraoperative anesthesia record forms, and computerized system of the hospital were screened.
  
  
  RESULTS
  A total of 2611 patients were assessed. In 7.4% of the patients, difficult intubations were detected. Difficult intubations were encountered in some of the patients with Mallampati scoring (MS) system Class 4 (50%), Cormack-Lehane classification (CLS) Grade 4 (95.7%), previous knowledge of difficult airway (86.2%), restricted neck movements (cervical ROM) (75.8%), short thyromental distance (TMD) (81.6%), vocal cord mass (49.5%) as indicated in parentheses (p<0.0001). MS had a low sensitivity, while restricted cervical ROM, presence of a vocal cord mass, short thyromental distance, and MS each had a relatively higher positive predictive value. Incidence of difficult intubations increased 6.159 and 1.736-fold with each level of increase in CLS grade and MS class, respectively. When all tests were considered in combination difficult intubation could be classified accurately in 96.3% of the cases.
  
  
  CONCLUSIONS
  Test results predicting difficult intubations in cases with DL had observedly overlapped with the results provided in the literature for the patient populations in general. Differences in some test results when compared with those of the general population might stem from the concomitant underlying laryngeal pathological conditions in patient populations with difficult intubation.
authors.affiliation: Departamento de Anestesiologia e Reanimação, Hospital Escola e de Pesquisa Corum, Universidade Hitit, Corum, Turquia.
authors.forename: Osman
authors.initials: O
authors.lastname: Karakus
authors.affiliation: Departamento de Anestesiologia e Reanimação, Faculdade de Medicina, Universidade Ondokuz Mayis, Samsun, Turquia. Electronic address: raufemre@yahoo.com.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Kaya
authors.affiliation: Departamento de Anestesiologia e Reanimação, Faculdade de Medicina, Universidade Ondokuz Mayis, Samsun, Turquia.
authors.forename: Faik Emre
authors.initials: FE
authors.lastname: Ustun
authors.affiliation: Departamento de Anestesiologia e Reanimação, Faculdade de Medicina, Universidade Ondokuz Mayis, Samsun, Turquia.
authors.forename: Ersin
authors.initials: E
authors.lastname: Koksal
authors.affiliation: Departamento de Anestesiologia e Reanimação, Faculdade de Medicina, Universidade Ondokuz Mayis, Samsun, Turquia.
authors.forename: Yasemin Burcu
authors.initials: YB
authors.lastname: Ustun
keywords: Endotracheal; Endotraqueal; Intubation; Intubação; Laringoscopia; Laryngoscopy; Otolaryngology; Otorrinolaringologia