Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Aug 2;16(3):232-6.
doi: 10.17305/bjbms.2016.1217. Epub 2016 Jun 14.

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

Nevena Kalezić  1 , Mirko Lakićević, Biljana Miličić, Marina Stojanović, Vera Sabljak, Dejan Marković
Affiliations

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

Nevena Kalezić et al. Bosn J Basic Med Sci. .

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.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Receiver-operating-characteristic (ROC) curve of the sensitivity and specificity of hyomental distance at the extreme of head extension (HMDe), hyomental distance ratio (HMDR), and the Mallampati group in predicting difficult intubation.
See this image and copyright information in PMC

References

    1. Wilson ME, Spiegelhalter D, Robertson JA, Lesser P. Predicting difficult intubation. Br J Anaesth. 1988;61(2):211–6. http://dx.doi.org/10.1093/bja/61.2.211 . - PubMed
    1. Kalezić N, Milosavljević R, Paunović I, Živaljević V, Diklić A, Matić D, et al. The incidence of difficult intubation in 2000 patients undergoing thyroid surgery-singlecenter experience. Vojnosanit Pregl. 2009;66(5):377–82. http://dx.doi.org/10.2298/VSP0905377K . - PubMed
    1. Noppens RR. Airway management in the intensive care unit. Acta Clin Croat. 2012;51(3):511–7. - PubMed
    1. Calder I, Calder J, Crockard HA. Difficult direct laryngoscopy in patients with cervical spine disease. Anaesthesia. 1995;50(9):756–63. http://dx.doi.org/10.1111/j.1365-2044.1995.tb06135.x . - PubMed
    1. Juvin P, Lavaut E, Dupont H, Lefevre P, Demetriou M, Dumoulin JL, et al. Difficult tracheal intubation is more common in obese than in lean patients. Anesth Analg. 2003;97(2):595–600. http://dx.doi.org/10.1213/01.ANE.0000072547.75928.B0 . - PubMed

MeSH terms