Reliability of the Thyromental Height Test for Prediction of Difficult Visualisation of the Larynx: A Prospective External Validation

Overview

Journal Indian J Anaesth

Specialty Anesthesiology

Date 2019 Apr 20

PMID 31000890

Citations 5

Authors

Shizuha Yabuki

Satoka Iwaoka

Mamoru Murakami

Hiroko Miura

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Thyromental height (TMH) has been reported to be useful for prediction of difficult visualisation of the larynx (DVL), defined as Cormack--Lehane (C&L) grade III or IV. The aim of this study was to compare the diagnostic accuracy of the TMH test for DVL with that of other clinically used tests in Japanese patients.

Methods: Six hundred and nine surgical patients undergoing endotracheal intubation under general anaesthesia were enrolled in this prospective observational study. TMH, thyromental distance (TMD), and Samsoon and Young's modified Mallampati (MMT) tests were performed in all patients. The C&L grades for the laryngoscopic view with and without external backward, upward, rightward pressure (BURP) were determined by designated airway assessors. The cutoff value for the TMH test was calculated using receiver-operating characteristic (ROC) curve analysis. The sensitivity, specificity, positive predictive value, accuracy, positive likelihood ratio, and area under the ROC curve (AUROC) for each predictive test were calculated and compared.

Results: ROC curve analysis indicated that 54 mm is the optimal cutoff value for the TMH test. However, both this value and the conventional cutoff value of 50 mm, which has been reported as having good diagnostic accuracy in the literature, had poor diagnostic accuracy. The AUROC for the TMH test was 0.631 without BURP and 0.592 with BURP; these values were not superior to those for the TMD test or MMT.

Conclusion: The TMH test is not a good predictor of DVL in Japanese patients.

Citing Articles

A Comparative Study to Evaluate Difficult Intubation Using Ratio of Patient Height to Thyromental Distance, Ratio of Neck Circumference to Thyromental Distance and Thyromental Height in Adult Patients in Tertiary Care Centre.

Rao S, Paliwal N, Saharan S, Bihani P, Jaju R, Sharma U Turk J Anaesthesiol Reanim. 2023; 51(2):90-96.

PMID: 37140573 PMC: 10210610. DOI: 10.5152/TJAR.2022.22077.

Use of the Thyromental Height Test for Prediction of Difficult Laryngoscopy: A Systematic Review and Meta-Analysis.

Chen W, Tian T, Li X, Jiang T, Xue F J Clin Med. 2022; 11(16).

PMID: 36013145 PMC: 9409656. DOI: 10.3390/jcm11164906.

Evaluation of thyromental height test in prediction of difficult airway in obese surgical patients: An observational study.

Ahmed A, Zaky M, El-Mekawy N, Ollaek M, Sami W, Mohamed D Indian J Anaesth. 2022; 65(12):880-885.

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Predictive performance of thyromental height for difficult laryngoscopies in adults: a systematic review and meta-analysis.

Carvalho C, Santos Neto J, Orange F Braz J Anesthesiol. 2021; 73(4):491-499.

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Study comparing different airway assessment tests in predicting difficult laryngoscopy: A prospective study in geriatric patients.

Panjiar P, Bhat K, Yousuf I, Kochhar A, Ralli T Indian J Anaesth. 2021; 65(4):309-315.

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