Comparison of Upper Lip Catch Test and Modified Mallampati Test for Predicting Difficult Airway in Edentulous Patients - A Prospective Observational Study

Abstract

Background: Unanticipated difficult airway, especially when associated with difficulty or lack of ventilation in anaesthetized patients, is still the main cause of morbidity and mortality. This difficult or failed intubation may be associated with life threatening complications such as hypoxic brain damage and death.

Aim: The aim of this study was to apply upper lip catch test for airway evaluation in edentulous patients undergoing elective surgery under General Anesthesia.

Methods: 159 Edentulous patients above 55 years of age of either sex, scheduled for elective surgery under General Anesthesia were selected for this prospective, observational study conducted at various associated hospitals of Government Medical College Srinagar after approval from Institutional Ethical Committee. The study was done over a period of one and a half year.  Upper lip catch test class and Modified Mallampati test class was assigned to patients during preoperative assessment. Cormack Lehane grading was recorded during intubation. Results of ULCT class and MMT class were compared with CLG. Upper lip catch test class and Modified Mallampati test class was assigned to patients during preoperative []\8assessment. Cormack Lehane grading was recorded during intubation. Results of ULCT class and MMT class were compared with CLG were taken in to consideration during the study period.

Results: Upper lip catch test (ULCT) was 61.54% sensitive and 83.46% specific for laryngoscopy difficulty diagnosis. The sensitivity and specificity for MPS were 53.85% and 81.95%, respectively. So, Upper lip catch test (ULCT) is more sensitive and more specific than MPS for laryngoscopy difficulty diagnosis. The positive predictive value for both ULCT and MPS were 42.11 and 36.84 respectively. The negative predictive values were high for both ULCT (91.74) and MPS (90.08).

Conclusion: The ULCT proved to be simple and useful predictor for airway evaluation in edentulous patients. Based on the findings from this study, we recommend routine use of Upper Lip Catch Test (ULCT) during airway assessment in edentulous patients.