Comparison of the performance of acromioaxillosuprasternal notch index with old method of anatomical measurement of head and neck in predicting laryngoscopy forecasting problems in pediatrics surgical procedures requiring tracheal intubation under general anesthesia

Abstract

Background: Nowadays, various methods are used to determine the difficulty of laryngoscopy. In this study, we aimed to compare the performance of the acromioaxillosuprasternal notch index (AASI) with the old anatomical criteria of the head and neck in predicting difficult laryngoscopy in pediatrics surgical procedures requiring tracheal intubation under general anesthesia. Methods: In this cross-sectional study, 379 children undergoing general anesthesia and intubation were divided into two groups based on easy (grades 1 and 2) and difficult (grades 3 and 4) laryngoscopy based on the score of Cormack-Lehane. The systems of thyromental distance, the ratio of height-to-thyromental distance (RHTMD), Upper lip bite test (ULBT), the circumference of the neck, and AASI were assessed and compared in predicting the difficulty of laryngoscopy. Findings: The laryngoscopic view was difficult in 48 patients (38 with grade 3 and 10 with grade 4). There was no significant difference between the two types of difficult and easy laryngoscopy based on thyromental distance, neck circumference, RHTMD, and AASI methods (P > 0.050); but there was a significant difference between two easy and difficult laryngoscopies based on ULBT and MMT methods (P < 0.050). The sensitivity of RHTMD, AASI, and neck circumference was 31.2, 47.9, and 51.1 percent, respectively, and specificity of them was 52.7, 45.6, and 48.9 percent, respectively. Conclusion: The neck circumference and then ASSI method is better than the RHTMD method, and the MMT method is better than the ULBT method in order to determine difficult laryngoscopy in children. © 2019, Isfahan University of Medical Sciences(IUMS). All rights reserved.