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Background: The ability
of a specific test to predict a difficult intubation is decreased by the
variability of definitions of difficult intubation/laryngoscopy. The Mallampati
classification system is a widely utilized approach for evaluating patients in
the preoperative setting. Zero class of Mallampati is a new class of airway
view that to add to the four modified Mallampati classes. This study estimates
the incidence of class zero airway and determines the ability of Mallampati
score, age and sex on the prediction of the larangoscopy grade.
Methods: This is a
cross sectional study in which 376 patients aged 7-18 years and A.S.A physical
status I or II were enrolled. They were scheduled for surgery under general
anesthesia All the airway assessments were done in the sitting position, with
the patient's head in neutral position, mouth fully open, tongue fully extended
and without phonation. After induction of general anesthesia, laryngoscopy
grade was assessed in sniffing position using the Cormak & Lehame grading
scale.
Results: Class zero
airways occurred in 0.3% of patients, and the patients with class zero airway
had a grade I laryngoscopy. 49.5% of patient had class I, 37.2% class II, 13%
of patient had class III and there found no patient with class IV airway. Grade
II and III laryngoscopy were more frequent in females than in males but this
correlation was not statistically significant.
Conclusions: Assessment
of airway by Mallampati scoring system and attention to the age can be an
important factor in the prediction of high laryngoscopy grade.
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