PROPOSAL OF A NEW MULTIFACTORIAL SCORE TO PREDICT DIFFICULT INTUBATION IN ENT AND STOMATOLOGICAL SURGERY - A PRELIMINARY-STUDY

This study assessed prospectively in 295 ENT adult patients the predictive value of clinical indicators for difficult intubation and of a new multifactorial score, established by the allocation of points (0, 3, 5 or 7) depending on the degree of presence of seven factors : pathology known to be associated with a difficult intubation, clinical signs of airways' pathology, inter-incisors gap and mandible's luxation, submental mandibular-thyroid distance, normal or short and broad neck, head and neck movements, and Mallampati's test. The incidence of difficult laryngoscopy was 14 % and the use of particular techniques for tube insertion was required in 8 % of patients. The presence of malformation or pathology often associated with a difficult intubation and the presence of functional signs of airways' pathology predict the difficulties of laryngoscopy and tracheal intubation with a good sensitivy and specificity. The analysis of the << Receiver Operating Characteristic curves >> showed that a score higher or equal to 11 allows the prediction of difficult intubations with a sensitivity of 96 % and a specificity of 90 %.