J Korean Dent Soc Anesthesiol.  2003 Jun;3(1):28-33. 10.17245/jkdsa.2003.3.1.28.

Airway Evaluation for Endotracheal Intubation of Mandibular Prognathic Patient

• Lee SJ
• Kim HJ
• Yum KW

• KMID: 2345178
• DOI: http://doi.org/10.17245/jkdsa.2003.3.1.28

Abstract

BACKGROUND
The fundamental responsibility of an anesthesiologist is to maintain adequate gas exchange. Failure to maintain a patent airway can result in brain damage or death. Generally, in patients with mandibular prognathism, who have the protruded mandible, the mask ventilation was thought to be not easy. The purpose of this study was to observe the degree of the difficulty of airway management in mandibular prognathism using some anatomic criteria for defining and grading difficulty of airway and difficulty of endotracheal intubation with direct laryngospoce.
METHODS
The observations and measurements are done to the 54 patients with mandibular prognathism, who were scheduled for corrective esthetic surgery. The case study is done to the 30 patients with normal mandible for control group. In all patients, mouth opening distance (MOD), mouse opening angle (MOA), mandibular length (ML), mandibular depth (MD), thyromental distance (TMD), thyromental area (TMA), Mallampati grades, and Cormack and Lehane grades are measured. T-test and Chi-square test are done (P < 0.05).
RESULTS
In the mandibular prognathism cases, the measurements of MD, TMD and TMA are more greater than those of controls (P < 0.05). Mallampati grades with tongue thrust are higher in the female mandibular prognathism cases than those of female controls. Most of the grades of the mandibular prognathism cases with Cormack and Lehane grading system are I or II being easy intubation cases (P < 0.05)
CONCLUSIONS
In the patients of mandibular prognathism, the intubation with laryngoscope will be easer than that of normal mandible in general. It is for that their laryngeal aperture can be easily visible when the laryngoscope are used.

Keyword

Airway evaluation; General anesthesia; Intubation; Prognathism

MeSH Terms

Airway Management
Anesthesia, General
Animals
Brain
Female
Humans
Intubation
Intubation, Intratracheal*
Laryngoscopes
Mandible
Masks
Mice
Mouth
Prognathism
Surgery, Plastic
Tongue
Ventilation