Difficult intubation what is the best one

We aimed to find a non-invazive test that can be used practical and mast concordant with direct laryngoscopy criters by comparing Cormace Lehane test with the other preoperative predictive difficult intubation tests. In our study 501 people who were followed in the previously treated brain surgery and diagnostic services and follow-inflicted lateral cervical radiograph was included. Age, sex, body, mass index, height were recorded as demographic data. The prediction test, as interincison gap test, mallampati test, upper lipe bite test, atluntooccipital joint extension, Wilson risk score, thyromental distance, sternomental distance, ratio height to thynomental distance, hyomental distance ratio were applied whole cases were compared these tests with cormace Lehane test that is direct larngoscopy classification. Also mandibulahyoid distance, hyoservikal distance, atlantooccipital distance and mandibular angle was measured by blinded radiologist. Significant increase was seen in probability of difficult intubiton correlated with gender and BMI when demographic data compared with easy and difficult intubiton. (p<0, 05). Difficult intubution ratio of %7,6 and failed intubiton was not seen. Multıvariate analysis independent predictors were analysed using logistic regression analysis.(p<0, 05 was accepted for statistical significance) According to the present analysis most sensitive tests to detect difficult intubation was found to mandibulahyoid distance, atlantooccipital joint extention, Wilson test, ratio height to thyromental distance. When the cases at difficult intubution test and Cormac Lehane test compared, statically significant differences determined between Mallampati classification, upper lip bite test, atlantooccipital joint extention, Wilson risk score, thyromental distance, sternomental distance, hyomental distance ratio at height to thyroment distance and Cormack Lehane, İİG test haved no significant difference. (P>0, 08). Also difficult mask ventilation capasity of the head neck movement and TMJ mobility tests were also significant Wilson risk score and ratio of height to thyremntal distance test was found as the most sensitive tests when they are used alone. In conclusion, we found that alone or together no tests in predicting difficulty in intubation hop suffeciently high sensitivity, specifity and pozitive predictivy values. On the other hand we think that ratio height to thyromental distance, Wilson risk score test, upper lip biting test, manndibulahyoid distance should be preferred.Because they are statistically significant higher. Key Words: Difficult İntubation, Upper Lip Bite Test,Mandibulahyoid Distance