2. Department of Anesthesiology and Reanimation, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
3. Department of Anesthesiology and Reanimation, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
4. Department of Public Health, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
Aim and background: The aim of the study is to investigate whether there is a relationship between difficult intubation and the structure of the nose in Eastern Black Sea Region of Turkey, where a higher incidence of difficult intubation in humans with typical nose structure is observed.
Materials and methods: Patients older than 18 years of age and having a physical ASA score of I-III were included in the study. Emergency and obstetrics cases, patients with a history of nasal trauma, nasal operation or airway anomaly, and patients lacking teeth were excluded from study. A total of 500 patients fulfilling these criteria were enrolled in the study. A novel nasal scale was developed as an objective bedside method to measure the prediction of difficult intubation. We compared the nasal scale’s ability to predict difficult intubation with available predictive tests. 500 patients scheduled for elective general anesthesia were evaluated preoperatively using the NS, MP, TRMD and SMD methods. Cormack and Lehane grades III and IV were accepted as difficult intubation.
Results: The value for the area under the ROC curve was 0.63 for NS. The specificity of NS (93.6%) was found to be higher than SMD and TRMD (89% and 71.2%, p<0.001; respectively) and lower than MP (97.9%; p<0.05). The accuracy of NS (85.8%) was higher than SMD and TRMD (69% and 82.8%, respectively) and lower than MP (96%).
Conclusions: The NS is an objective and specific test that can be easily applied and can supplement the existing tests.
Keywords: Nose, scoring system, mallampati, thyromental distance, sternomental distance, difficult intubation