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Indian Journal of Clinical Anaesthesia

Neck circumference to thyromental distance ratio: Is a reliable predictor of difficult intubation in obese patients?

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Author Details : Vrishali R. Ankalwar*, Manish Patel, Naresh G. Tirpude

Volume : 6, Issue : 1, Year : 2019

Article Page : 152-156

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Introduction: The present study was carried out to evaluate the efficacy of neck circumference to thyromental distance (NC/TM) ratio to predict difficult intubation in obese patients on background of routinely practiced Modified Mallampati Classification (MMC).
Materials and Methods: Total 60 obese patients (BMI ? 30 kg/m2) of either sex were studied in the present study. Difficult intubation was predicted by using both NC/TM ratio and modified Mallampati score. Intubation difficulties were noted using Intubation Difficulty Scale (IDS) while performing laryngoscopy and intubation.
Results: NC/TM ratio showed higher sensitivity (92.31%), higher negative predictive value (93.75%) and higher area under curve (AUC=0.73) on the ROC curve than MMC score and also found that NC/TM ratio was statistically significant independent risk factor of difficult intubation (p value <0>
Conclusion: NC/TM ratio can be considered as reliable and better bedside screening test for predicting intubation difficulties in obese patients.

Keywords: Neck circumference, Thyromental distance, Modified Mallampati classification, Obese, Intubation.

Doi : 10.18231/2394-4994.2019.0029

How to cite : Ankalwar V R, Patel M, Tirpude N G, Neck circumference to thyromental distance ratio: Is a reliable predictor of difficult intubation in obese patients?. Indian J Clin Anaesth 2019;6(1):152-156

Copyright © 2019 by author(s) and Indian J Clin Anaesth. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (