Determination of the Accuracy of Thyromental Height Test for Predicting Difficult Laryngoscopy in Obstetric Patients Who Are Candidates for Cesarean Section: An Observational Study
ABSTRACT: Background: Pregnant women frequently have face and upper airway edema, which makes managing the airways during anesthesia difficult and increases the risk of mask breathing complications and intubation failure. This necessitates an investigation into the sensitivity of various airway tes...
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Elsevier
2025-01-01
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| Series: | Current Therapeutic Research |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0011393X25000098 |
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| author | Saghar Samimi Sadeh, MD Babak Moayer, MD Masoomeh Natajmajd, MD Parisa Kianpour, PharmD Kousha Farhadi, MD Mahgol Etezadi, PharmD Mojgan Rahimi, MD Farhad Etezadi, MD |
| author_facet | Saghar Samimi Sadeh, MD Babak Moayer, MD Masoomeh Natajmajd, MD Parisa Kianpour, PharmD Kousha Farhadi, MD Mahgol Etezadi, PharmD Mojgan Rahimi, MD Farhad Etezadi, MD |
| author_sort | Saghar Samimi Sadeh, MD |
| collection | DOAJ |
| description | ABSTRACT: Background: Pregnant women frequently have face and upper airway edema, which makes managing the airways during anesthesia difficult and increases the risk of mask breathing complications and intubation failure. This necessitates an investigation into the sensitivity of various airway tests in predicting difficult intubation. Objective: To assess the accuracy of the thyromental height test (TMHT) in predicting difficult laryngoscopy in obstetric patients undergoing cesarean section and to compare its effectiveness with other airway assessment methods. Methods: We included a cohort of obstetric patients, approved by the Ethics Committee of Tehran University of Medical Sciences, scheduled for elective cesarean sections. During laryngoscopy, preoperative evaluations of the airway were done. The primary aim was to determine the relationship between TMHT (the distance between mentum and the thyroid cartilage) and the Cormack-Lehane (which categories laryngoscopy view from fully observable vocal cords to nonvisible epiglottis) classification, which indicates the level of difficulty in laryngoscopy. Results: After eligibility assessment, 156 patients entered the study, of which 16 had Cormack-Lehane grades III and IV and were considered difficult laryngoscopy. The TMHT demonstrated a higher Matthews correlation coefficient (0.695), sensitivity (0.75), and specificity (0.96) compared with other tests, suggesting that TMHT has the potential to serve as a dependable predictor of challenging laryngoscopy. Conclusions: The use of TMHT can improve patient outcomes and the preoperative evaluation process, making it a valuable tool for anesthesiologists managing obstetric patients. The TMHT could be considered a complementary tool to existing airway assessment methods, particularly in obstetric patients, due to its high predictive accuracy and ease of use.This study is registered at Iranian Registry of Clinical Trial (IRCT) under identifier code of IR.TUMS.SINAHOSPITAL.REC.1399.061. |
| format | Article |
| id | doaj-art-822c3a079e034d6ebf2efd98d3bab61b |
| institution | OA Journals |
| issn | 0011-393X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | Current Therapeutic Research |
| spelling | doaj-art-822c3a079e034d6ebf2efd98d3bab61b2025-08-20T02:35:44ZengElsevierCurrent Therapeutic Research0011-393X2025-01-0110210078410.1016/j.curtheres.2025.100784Determination of the Accuracy of Thyromental Height Test for Predicting Difficult Laryngoscopy in Obstetric Patients Who Are Candidates for Cesarean Section: An Observational StudySaghar Samimi Sadeh, MD0Babak Moayer, MD1Masoomeh Natajmajd, MD2Parisa Kianpour, PharmD3Kousha Farhadi, MD4Mahgol Etezadi, PharmD5Mojgan Rahimi, MD6Farhad Etezadi, MD7Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran, IranDepartment of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran, IranDepartment of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran, IranAnesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, IranAnesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, IranStudent Research Committee, Pharmacy Faculty, Tehran University of Medical Sciences, Tehran, IranDepartment of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IranAnesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran; Address correspondence to: Farhad Etezadi, Anesthesia, Critical Care and Pain Management Research Center, Sina Hospital, Hasanabad Sq., Imam Khomeini Ave., Tehran, Iran.ABSTRACT: Background: Pregnant women frequently have face and upper airway edema, which makes managing the airways during anesthesia difficult and increases the risk of mask breathing complications and intubation failure. This necessitates an investigation into the sensitivity of various airway tests in predicting difficult intubation. Objective: To assess the accuracy of the thyromental height test (TMHT) in predicting difficult laryngoscopy in obstetric patients undergoing cesarean section and to compare its effectiveness with other airway assessment methods. Methods: We included a cohort of obstetric patients, approved by the Ethics Committee of Tehran University of Medical Sciences, scheduled for elective cesarean sections. During laryngoscopy, preoperative evaluations of the airway were done. The primary aim was to determine the relationship between TMHT (the distance between mentum and the thyroid cartilage) and the Cormack-Lehane (which categories laryngoscopy view from fully observable vocal cords to nonvisible epiglottis) classification, which indicates the level of difficulty in laryngoscopy. Results: After eligibility assessment, 156 patients entered the study, of which 16 had Cormack-Lehane grades III and IV and were considered difficult laryngoscopy. The TMHT demonstrated a higher Matthews correlation coefficient (0.695), sensitivity (0.75), and specificity (0.96) compared with other tests, suggesting that TMHT has the potential to serve as a dependable predictor of challenging laryngoscopy. Conclusions: The use of TMHT can improve patient outcomes and the preoperative evaluation process, making it a valuable tool for anesthesiologists managing obstetric patients. The TMHT could be considered a complementary tool to existing airway assessment methods, particularly in obstetric patients, due to its high predictive accuracy and ease of use.This study is registered at Iranian Registry of Clinical Trial (IRCT) under identifier code of IR.TUMS.SINAHOSPITAL.REC.1399.061.http://www.sciencedirect.com/science/article/pii/S0011393X25000098airway assessmentcesarean sectiondifficult laryngoscopyobstetric anesthesiathyromental height |
| spellingShingle | Saghar Samimi Sadeh, MD Babak Moayer, MD Masoomeh Natajmajd, MD Parisa Kianpour, PharmD Kousha Farhadi, MD Mahgol Etezadi, PharmD Mojgan Rahimi, MD Farhad Etezadi, MD Determination of the Accuracy of Thyromental Height Test for Predicting Difficult Laryngoscopy in Obstetric Patients Who Are Candidates for Cesarean Section: An Observational Study Current Therapeutic Research airway assessment cesarean section difficult laryngoscopy obstetric anesthesia thyromental height |
| title | Determination of the Accuracy of Thyromental Height Test for Predicting Difficult Laryngoscopy in Obstetric Patients Who Are Candidates for Cesarean Section: An Observational Study |
| title_full | Determination of the Accuracy of Thyromental Height Test for Predicting Difficult Laryngoscopy in Obstetric Patients Who Are Candidates for Cesarean Section: An Observational Study |
| title_fullStr | Determination of the Accuracy of Thyromental Height Test for Predicting Difficult Laryngoscopy in Obstetric Patients Who Are Candidates for Cesarean Section: An Observational Study |
| title_full_unstemmed | Determination of the Accuracy of Thyromental Height Test for Predicting Difficult Laryngoscopy in Obstetric Patients Who Are Candidates for Cesarean Section: An Observational Study |
| title_short | Determination of the Accuracy of Thyromental Height Test for Predicting Difficult Laryngoscopy in Obstetric Patients Who Are Candidates for Cesarean Section: An Observational Study |
| title_sort | determination of the accuracy of thyromental height test for predicting difficult laryngoscopy in obstetric patients who are candidates for cesarean section an observational study |
| topic | airway assessment cesarean section difficult laryngoscopy obstetric anesthesia thyromental height |
| url | http://www.sciencedirect.com/science/article/pii/S0011393X25000098 |
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