Predictive variables for difficult intubations in oral and maxillofacial surgery.

ABSTRACT

SUMMARY: Many factors affect the difficulty of endotracheal intubation some of which are related to the condition of the patients. A few assessment tools have been developed to predict intubation difficulty but none is all inclusive thereby being inadequate for comprehensive and accurate evaluation. We assessed the usefulness of four categories of predictive variables namely; the LEMON score, Demographic indices, Tumour site and Intraoral Position of tumour (IOP), in predicting intubation difficulty among a group of patients with orofacial tumours. By statistical analysis, a significant correlation between predictions by LEMON score and actual intubation difficulty was observed while neck mobility (P=0.28) and Mallampati scores (P=0.49) were the most important criteria in the scoring system. Significant association was also observed with demographic indices and difficulty whereby the Optimal Interincisal Distance (OID) had the greatest impact (P=0.048). There was no difference in the difficulty posed by the different sites and intraoral positions of tumours in this study. We therefore suggest the adoption of the LEMON score and consideration of the demographic indices when assessing patients with orofacial tumours for intubation difficulty. Three important variables should be given greater value, these are, neck mobility, Mallampatti score and optimal interincisal distance.