Effects of airway evaluation parameters on the laryngeal view grade in mandibular prognathism and retrognathism patients
감명환, 지성인, 김지민, 김현정, 서광석, 박재현, 박창주,
소속 상세정보
감명환 ( Karm Myong-Hwan ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
지성인 ( Chi Seong-In ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
김지민 ( Kim Ji-Min ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
김현정 ( Kim Hyun-Jeong ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
서광석 ( Seo Kwang-Suk ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
박재현 ( Bahk Jae-Hyon ) - Seoul National University College of Medicine Department of Anesthesiology and Pain Medicine
박창주 ( Park Chang-Joo ) - Hanyang University College of Medicine Department of Dentistry Division of Oral and Maxillofacial Surgery
KMID : 0980320160160030185
Abstract
Background: Failure to maintain a patent airway can result in brain damage or death. In patients with mandibular prognathism or retrognathism, intubation is generally thought to be difficult. We determined the degree of difficulty of airway management in patients with mandibular deformity using anatomic criteria to define and grade difficulty of endotracheal intubation with direct laryngoscopy.
Methods: Measurements were performed on 133 patients with prognathism and 33 with retrognathism scheduled for corrective esthetic surgery. A case study was performed on 89 patients with a normal mandible as the control group. In all patients, mouth opening distance (MOD), mandibular depth (MD), mandibular length (ML), mouth opening angle (MOA), neck extension angle (EXT), neck flexion angle (FLX), thyromental distance (TMD), inter-notch distance (IND), thyromental area (TMA), Mallampati grade, and Cormack and Lehane grade were measured.
Results: Cormack and Lehane grade I was observed in 84.2%, grade II in 15.0%, and grade III in 0.8% of mandibular prognathism cases; among retrognathism cases, 45.4% were grade I, 27.3% grade II, and 27.3% grade III; among controls, 65.2% were grade I, 26.9% were grade II, and 7.9% were grade III. MOD, MOA, ML, TMD, and TMA were greater in the prognathism group than in the control and retrognathism groups (P < 0.05). The measurements of ML were shorter in retrognathism than in the control and prognathism groups (P < 0.05).
Conclusions: Laryngoscopic intubation was easier in patients with prognathism than in those with normal mandibles. However, in retrognathism, the laryngeal view grade was poor and the ML was an important factor.
키워드
Airway; Intubation; Prognathism; Retrognathism
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