Hyomental distance in the different head positions and hyomental distance ratio in predicting difficult intubation

Nevena Kalezić; Mirko Lakićević; Biljana Miličić; Marina Stojanović; Vera Sabljak; Dejan Marković

doi:10.17305/bjbms.2016.1217

Authors

Nevena Kalezić School of Medicine, University of Belgrade
Mirko Lakićević Clinical Hospital Center Zemun, Belgrade
Biljana Miličić Clinical Center of Serbia, Belgrade
Marina Stojanović Clinical Center of Serbia, Belgrade
Vera Sabljak School of Medicine, University of Belgrade
Dejan Marković School of Medicine, University of Belgrade

DOI:

https://doi.org/10.17305/bjbms.2016.1217

Keywords:

Laryngoscopy, Airway, Difficult intubation, Hyoid bone, Chin, The hyomental distance ratio

Abstract

The hyomental distance ratio (HMDR) is the ratio between the hyomental distance (HMD) (the distance between the hyoid bone and the tip of the chin) at the extreme of head extension (HMDe) and the one in the neutral position (HMDn). The objective of the study was to examine the predictive value, sensitivity, and specificity of HMDe, HMDn, and HMDR in predicting difficult endotracheal intubation (DI). A prospective study included 262 patients that underwent elective surgical operations. The following parameters were observed as possible predictors of DI: HMDR, HMDe, HMDn, Mallampati score, and body mass index (BMI). The cut-off points for the DI predictors were HMDe <5.3 cm, HMDn ≤5.5 cm, and HMDR ≤1.2. The assessment that DI existed was made by the anesthesiologist while performing laryngoscopy by applying the Cormack-Lehane classification. DI was present in 13 patients (5%). No significant difference was observed in the frequency of DI with regard to the sex, age, and BMI of the patients. Our research indicated HMDR as the best predictor of DI with a sensitivity of 95.6% and specificity of 69.2%. HMDR can be used in the everyday work of anesthesiologists because HMDR values ≤1.2 may reliably predict DI.

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Author Biographies

Nevena Kalezić, School of Medicine, University of Belgrade

MD, PhD
Mirko Lakićević, Clinical Hospital Center Zemun, Belgrade

MD
Biljana Miličić, Clinical Center of Serbia, Belgrade

MD, PhD
Marina Stojanović, Clinical Center of Serbia, Belgrade

MD
Vera Sabljak, School of Medicine, University of Belgrade

MD
Dejan Marković, School of Medicine, University of Belgrade

MD,PhD

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