Comparison of Mallampatti Test, Thyromental Distance and Distance from Tragus to Nares for Predicting Difficult Intubation in Pediatric Patients


Clinical criteria for prediction of difficult airway in adults may not be applicable in children and available literature on the topic is limited. The objective of this prospective observational study was to assess the usefulness of Mallampati classification, thyromental distance (Tm) and distance from tragus to nares (Tn) in two groups of pediatric patients, those who are less than five and above five years of age, and to correlate these assessments with different grades of Cormack and Lehane (C&L) classification. One hundred and ninety six pediatric patients from one month to eight years of age, ASA grade I and II and planned for elective surgery under general anesthesia with tracheal intubation were recruited. Age, gender, weight (kg), BMI, distance between tragus and nares (cm), Mallampati grades and thyromental distance (cm) were noted preoperatively. Relationship of these variables with C&L grading at the time of laryngoscopy was recorded. C&L grades 2 & 3 was observed in 28 patients in younger age group (n = 120) as compared to two children above 5 years (n = 76) (p < 0.001). C&L grade 3 was seen with decreasing tragus to nares distance (p < 0.002) and with decreasing Tm distance (p = 0.025) in younger age group. In conclusion, this study showed that distance between tragus to nares, Mallampati classification (if applicable) and thyromental distance can be useful for assessment of difficult airway in children less than five years of age.

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Rafique, N. and Khan, F. (2014) Comparison of Mallampatti Test, Thyromental Distance and Distance from Tragus to Nares for Predicting Difficult Intubation in Pediatric Patients. Open Journal of Anesthesiology, 4, 104-109. doi: 10.4236/ojanes.2014.44016.

Conflicts of Interest

The authors declare no conflicts of interest.


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