Original Article

Sensitivity of the Combination of Mallampati Scores with Anthropometric Measurements and the Presence of Malignancy to Predict Difficult Intubation


  • Tünay Kandemir
  • Serpil Şavlı
  • Süheyla Ünver
  • Erbin Kandemir

Received Date: 17.10.2013 Accepted Date: 26.12.2013 Turk J Anaesthesiol Reanim 2015;43(1):7-12


The aim of this study was to determine the combinations of the Mallampati test and anthropometric measurements with the highest selectivity value. In addition, we aim to identify a possible correlation between head circumference measurement, the presence of malignancy and difficult intubation.


Patients who were scheduled to undergo elective surgery under general anaesthesia, who fell into Group 1-2 according to ASA criteria and were between the ages of 18-70 years were included in the study. Patients with Cormack-Lehane scores of 3-4 were considered to be difficult intubations. Thyromental distance, sternomental distance, mandibular distance, neck length, neck circumference and head circumference were measured during the anthropometric measurements.


According to the ROC analysis, there was a significant difference in the thyromental distance, sternomental distance, neck length, neck circumference and head circumference between the easy and difficult intubation groups (p<0.05). The incidence of difficult intubation was 8.3% in patients with non-head-neck malignancies, whereas the incidence was 7.1% in patients without any malignancies. The difference between these groups was not statistically significant (χ2 =0.101; p=0.751).


To predict the incidence of difficult intubation, the test with the highest selectivity and highest positive predictive values was the combination of Mallampati-thyromental distance. We believe that the head circumference and neck length measurement, in addition to the current anthropometric measurements, may be crucial to predict the incidence of difficult intubations. In addition, we believe that the anticipation of difficult intubations in patients with non-head-neck malignancies is not different from the normal population.

Keywords: Difficult intubation, Mallampati, anthropometric measurements, malignancy, head circumference