Journal of Biomedical Sciences

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Prediction of Difficult Intubation with the Modified Mallampati and Upper Lip Bite Test: A Cross-Sectional Analysis

Muhammad Tayyeb, Shah Faisal, Abdullah*, Muhammad Ajmal, Naqash Ahmad, Muhammad Arsalan, Ayesha Jehad, Bashir ul Haq, Said Khitab Shah, and Muhammad Qasim Jan

Difficult intubation is a term used when insertion of the endotracheal tube with conventional laryngoscopy technique requires more than 10 minutes or greater than three attempts. This study sought to determine the predictive value of two commonly used tests; Mallampati test vs. Upper Lip Bite Test (ULBT). A cross-sectional study conducted on 196 patients aged 18-60 years in lady reading hospital Peshawar presented for elective surgeries planned for general anaesthesia and requiring endotracheal intubation were included during March 2018 to May 2018. Both tests (Mallampati and Upper lip bite test) were performed on each sample. In the total 196 participant 180 (91.8%) were found easy cases and 16 (8.2%) were difficult cases. Out of 16 (8.2%) difficult cases 5 (31.3%) difficult cases were underclass III Upper Lip Bite Test (ULBT) which are true positive. From Modified Mallampati Test 8 (50%) were attributed to MMT class III which is 21.1% of total class III and 3 cases (18.8% of total difficult cases) with MMT class IV which is 75% of MMT class IV are both true positive. During anaesthesia and intubation, most common cause of death and brain damage is encounter because of difficult intubation. In this study, we have performed two tests i.e. ULBT and MMT on total of 196 patients, out of which 16 (8.2%) were found difficult intubation which is in the range (0.5- 17.5%) mention in the previous studies. The study has shown most of the difficult were predicted incorrectly. Most cases resulted in difficult intubation, which were predicted easily by two tests (Criteria set by Hoda et al.), so to only rely on ULBT and MMT for predictive measure is not standard.