Diagnostic value of the upper lip bite test in predicting difficulty in intubation with head and neck landmarks obtained from lateral neck X-ray

Khan, Zahid Hussain; Arbabi, Shahriar

doi:10.4103/0019-5049.118567

Cited by 20 publications

(10 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We observed a high accuracy of ULBT (>85%) in 24 of 27 studies meaning that ULBT has an optimal diagnostic value in preoperative assessment of patients candidate for general anesthesia. 4 , 5 , 12 - 14 , 17 - 25…”

Section: Discussionmentioning

confidence: 99%

Upper lip bite test for prediction of difficult airway: A systematic review

Faramarzi¹,

Soleimanpour²,

Khan³

et al. 2018

Pak J Med Sci

View full text Add to dashboard Cite

Background and Objective:Upper lip bite test (ULBT) is one of the various bedside tests used for prediction of difficult laryngoscopic intubation. However, its usefulness is not still very clear, and there is controversy regarding its accuracy. The aim of this systematic review was to determine the accuracy of the ULBT for predicting difficult airway including difficult laryngoscopy or difficult tracheal intubation.Method:We searched the databases of PubMed, Scopus, and Google scholar for prospective studies published up until October 2016 assessing the accuracy of ULBT in comparison to Cormack-Lehane grading. The selected keywords were “upper lip bite test”, “upper lip catch test”, “prediction”, “difficult airway”, “difficult laryngoscopy”, “difficult intubation”. Inclusion criteria were studies assessing ULBT for prediction of difficult intubation, considering Cormack-Lehane grade III and IV as difficult airway, written in English, and reporting sensitivity, specificity, NPV, PPV, and accuracy. Exclusion criteria were studies not reporting accuracy or not having enough data for its calculation. Based on the mentioned criteria, 27 studies enrolling 18141 patients were included. This systematic review was performed based on the guidelines on conducting systematic reviews of diagnostic studies.Results:Prevalence of airway difficulties according to the direct laryngoscopic view varied from 2.8% to 27% and according to the ULBT was from 2% to 21%. In 11 of the 27 studies, sensitivity of ULBT in prediction of difficult airway was more than 70%. All of the studies except one showed a high specificity for ULBT (>85%). Moreover, these studies indicated a high NPV. Accuracy of ULBT was >85% in 24 out of 27 studies.Conclusion:It appears that ULBT is a useful bedside test for evaluation of patient airway before the general anesthesia.

show abstract

Section: Discussionmentioning

confidence: 99%

Upper lip bite test for prediction of difficult airway: A systematic review

Faramarzi¹,

Soleimanpour²,

Khan³

et al. 2018

Pak J Med Sci

View full text Add to dashboard Cite

show abstract

“…[ 6 7 ] However, there are very few studies comparing upper lip bite test (ULBT) and ratio of height to TMD (RHTMD) with other screening tests. [ 8 9 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of upper lip bite test and ratio of height to thyromental distance with other airway assessment tests for predicting difficult endotracheal intubation

Badheka

Doshi

Vyas

et al. 2016

Indian Journal of Critical Care Medicine

View full text Add to dashboard Cite

Background:Various anatomical measurements and noninvasive clinical tests, singly or in various combinations can be performed to predict difficult intubation. Upper lip bite test (ULBT) and ratio of height to thyromental distance (RHTMD) are claimed to have high predictability. Hence, we have conducted this study to compare the predictive value of ULBT and RHTMD with the following parameters: Mallampati grading, inter-incisor gap, thyromental distance, sternomental distance, head and neck movements, and horizontal length of mandible for predicting difficult intubation.Materials and Methods:In this single blinded, prospective, observational study involving 170 adult patients of either sex belonging to American Society of Anesthesiologists physical Status I–III scheduled to undergo general anesthesia were recruited. All patients were subjected to the preoperative airway assessment and, the above parameters were recorded correlated with Cormack and Lehane grade and analyzed. The number of intubation attempts and use of intubation aids were also noted.Results:ULBT and RHTMD had highest sensitivity (96.64%, 90.72%), specificity (82.35%, 80.39%), positive predictive value (92.74%, 91.53%), and negative predictive value (91.3%, 78.8%), respectively, compared to other parameters. While odds ratio and likelihood ratio >1 for all the tests.Conclusion:ULBT can be used as a simple bedside screening test for prediction of difficult intubation, but it should be combined with other airway assessment tests for better airway predictability. RHTMD can also be used as an acceptable alternative.

show abstract

“…2,5,8 Although the number of patients enrolled in these studies were limited in a study with large Iranian population, ULBT has also been shown to be superior to variables derived from radiological measurements. 2,3,5,10 However, ULBT was found to be a poor predictor of difficult laryngoscopy in a North American patient population. 12 These observed discrepancies may be due to the fact that there occurs substantial interobserver variability while measuring SMD, TMD and IID, wheras ULBT is associated with less interobserver variability.…”

Section: Discussionmentioning

confidence: 98%

“…1 Although many bedside preoperative methods of assessment of the airway and their combinations have been evaluated to predict the possibility of difficult airway, there is conflicting data regarding their accuracy. 2,3 Moreover, many preoperative airway tests are found to have only fair interobserver reproducibility. 4 Khan Z. H., et al have proposed that the Upper Lip Bite Test (ULBT) could serve as a good predictor of difficult laryngoscopic intubation.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study of the Usefullness of Upper Lip Bite Test in Combination With Sterno - Mental Distance, Thyro - Mental Distance and Inter - Incisor Distance as Predictor of Ease of Laryngoscopy

Konwar¹,

Baruah²,

Saikia³

et al. 2015

jemds

View full text Add to dashboard Cite

BACKGROUNDUpper Lip Bite Test (ULBT) has been evaluated as a simple bedside test to predict the grade of laryngeal visualisation. As the utility of this test is not yet evaluated in patients from this geographical location of India, we intend to investigate whether the combination of the ULBT classification with Sternomental Distance (SMD), Thyromental Distance (TMD), and Inter-Incisor Distance (IID) to predict easy laryngoscopy and compared with each test alone.

show abstract

Diagnostic value of the upper lip bite test in predicting difficulty in intubation with head and neck landmarks obtained from lateral neck X-ray

Cited by 20 publications

References 35 publications

Upper lip bite test for prediction of difficult airway: A systematic review

Upper lip bite test for prediction of difficult airway: A systematic review

Comparison of upper lip bite test and ratio of height to thyromental distance with other airway assessment tests for predicting difficult endotracheal intubation

A Prospective Study of the Usefullness of Upper Lip Bite Test in Combination With Sterno - Mental Distance, Thyro - Mental Distance and Inter - Incisor Distance as Predictor of Ease of Laryngoscopy

Contact Info

Product

Resources

About