Journal articles: 'Upper lip bite test (ULBT)'

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S, Ajanth, Vinayak Sirsat, S. Chauhan, and Deepak M. Kokane. "Comparative Study of Upper Lip Bite Test and Modified Mallampatti Classification in Predicting Difficult Endotracheal Intubation." Indian Journal of Anesthesia and Analgesia 8, no. 6 (2021): 563–69. http://dx.doi.org/10.21088/ijaa.2349.8471.8621.82.

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Objective: To compare sensitivity, specificity, positive and negative predictive values of upper lip bite test and modified mallampatti test to predict difficulty in endotracheal intubation in patients between 16 to 55 years of age. Methods: One hundred ASA1/2 patients admitted for elective surgical procedure requiring endotracheal intubation were prospectively studied to predict difficult intubation in age group 16-55 years of age after obtaining an informed consent. Preoperative Airway assessment was done with modified mallampatti test and upper lip bite test. Results: In our study, eighty four had Upper lip bite test (ULBT) class I and II and sixteen patients had class III. Of these two ofthe ULBT class Iand II and five of the ULBTclassIII had Cormack Lehane grade III . There were one hundred patients predicted to be easy for intubation by MMT (i.e. patients who had ULBT class I and II) out of whom however, we encountered difficult intubation in 6 patients. One in MMT class III also had difficult intubation. None of the patients had class IV MMT.Of the entire one hundred patients, a total of seven patients had difficult intubation, all of whom had Cormack Lehane class III on laryngoscopy. Conclusion: Upper Lip Bite Test (ULBT)is a better test at predicting difficult endotracheal intubation when compared toModified Mallampati Test (MMT). Upper lip bite test and modified mallampatti classification are good predictors of easy intubation rather than difficult intubation. Upper lip bite test should be used in combination with other airway assessment methods viz. Thyromental distance, hyomental distance, inter incisor distance to predict difficult intubation.

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Bukhari, Dr Sadaf, Dr Aaifa Khalid Niazi, and Dr Hajra Shuja. "ACCURACY OF UPPER LIP BITE TEST IN PREDICTING DIFFICULT AIRWAY." Professional Medical Journal 25, no. 12 (2018): 1966–71. http://dx.doi.org/10.29309/tpmj/18.496.

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INTRODUCTION: Various anatomical measurements and non‑invasive clinical tests can be performed to predict difficult intubation. Recently introduced “Upper lip bite test” (ULBT) is claimed to have a high predictability. However, limited data exists to support its high predictability both nationally and internationally. OBJECTIVE: To determine the diagnostic accuracy of upper lip bite test in the prediction of difficult airway. METHODOLOGY: This was a cross sectional study. A sample of 283 patients was calculated by using WHO sample size calculator and sampling was done by non-probability consecutive sampling. All the selected patients were assessed for upper lip bite test and Cormack and Lehane laryngoscopy grade separately. Data was collected on pre-designed proforma. Accuracy of ULBT was calculated based on the acquired data. RESULTS: The calculated accuracy of ULBT for predicting difficult airway was found to be 91.2%. CONCLUSION: ULBT is a reliable bedside technique with a high accuracy for predicting a difficult airway. KEY WORDS: Upper lip bite test, Cormack and Lehane scale, difficult airway.

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Koirala, Sabin, Bigen Man Shakya, and Moda Nath Marhatta. "Comparison of Upper Lip Bite Test with Modified Mallampati Test and Thyromental Distance for Prediction of Difficult Intubation." Nepal Journal of Medical Sciences 5, no. 1 (2020): 2–9. http://dx.doi.org/10.3126/njms.v5i1.36792.

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Introduction: The prediction of difficult intubation using simple bedside test is of great importance to prevent mismanagement of airway. This study was conducted to compare Upper Lip Bite Test (ULBT) with Modified Mallampati Test (MMT) and Thyromental Distance (TMD) for the prediction of difficult intubation. Method: This was descriptive cross-sectional study conducted in 121 patients of American Society of Anaesthesiologists Physical Status (ASA PS) I and II patients scheduled for elective surgery requiring general anaesthesia with endotracheal tube. The airway assessment of the patients was done one day prior to the surgery using Upper Lip Bite Test (ULBT), Modified Mallampati Test (MMT) and measurement of Thyromental Distance (TMD) . On the day of surgery during laryngoscopy, Cormack-Lehane (CL) grading was recorded. The CL grading of III and IV was labeled as difficult intubation. The Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), Likelihood Ratio (LR) of ULBT, MMT and TMD were calculated and compared. Results: The total percentage of difficult intubation, defined by Cormack-Lehane (CL) III and IV was 16.52 %. The sensitivity, specificity, PPV, NPV and accuracy of Upper Lip Bite Test (ULBT) was 50%, 100%, 100%, 91% and 91.74% respectively. ULBT had a significantly higher sensitivity, specificity and PPV when compared to MMT or TMD or MMT and TMD when combined together. Conclusions: Upper Lip Bite Test (ULBT) is better predictor of difficult intubation and it should be used along with other test during airway assessment.

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CHOHEDRI, ABDUL-HAMEED, MASOOMEH TABARI, and ELAHE ALLAHYARI. "THE UPPER LIP BITE TEST." Professional Medical Journal 12, no. 04 (2005): 440–45. http://dx.doi.org/10.29309/tpmj/2005.12.04.5097.

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Objective: We conducted a prospective, double-blind study todetermine whether a difficult endotracheal intubation could be predicted preoperatively by a simple new technique, theupper lip bite test and compared it with three other tests used for prediction of difficult intubation: Modified Mallampaticriteria (MMC), Thyromental distance (TM) and Mouth opening (MO). Materials and Methods: Five hundred patients,aged above 16 years, and presenting for elective surgery were subjected to the following assessments: (1) Upper lipbite test (ULBT), class I: lower incisors can bite the upper lip above the vermilion line; class II: lower incisors can bitethe upper lip below the vermilion line; class III: lower incisors cannot bite the upper lip; (2) Oropharyngeal classaccording to the MMC. (3) The distance between the chin and thyroid cartilage (thyromental distance). (4) Extend ofmaximum mouth opening test. Results: ULBT had significantly higher accuracy (96%) and specificity (98.3%) and thelowest rate of false positive (p< 0.001). The most sensitive test was the TM test (42%). Conclusion: We concludedthat comparison of the three tests, UPBT has sufficient value in predicting difficult intubation in adults

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Dawood, Ahmed Salam, Bashar Zuhair Talib, and Istabraq Sadoon Sabri. "PREDICTION OF DIFFICULT INTUBATION BY USING UPPER LIP BITE, THYROMENTAL DISTANCE AND MALLAMPATI SCORE IN COMPARISON TO CORMACK AND LEHANE CLASSIFICATION SYSTEM." Wiadomości Lekarskie 74, no. 9 (2021): 2305–14. http://dx.doi.org/10.36740/wlek202109211.

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The aim: To evaluate efficacy of Modified Mallampati test (MMT), upper lip bite test (ULBT) and Thyromental distance (TMD) or combination of two method Modified Mallampati test (MMT)+ upper lip bite test (ULBT), Thyromental distance (TMD) + upper lip bite test (ULBT) in prediction of difficult intubation in patients undergoing GA. Materials and methods: Three tests were carried out in all patients by a single anesthesiologist. These were MMT, ULBT and TMD. Laryngoscopy was performed with patient’s head in the sniffing position. The laryngoscopy view was graded according to modified Cormack and Lehane classification system. Study was prospective, single cross sectional, in 151 adult patients who required GA with endotracheal intubation for elective surgery. On arrival in the operating room, routine monitoring and venous cannula were introduced. Midazolam, Fentanyl. and rocuronium, ketamine , propofol were given to facilitate endotracheal intubation. Results: Out of 150 assessed patients, 18 (12%) had difficult intubation. Of those 18 patients, 17 (83.33%) patients had Cormack and Lehane classification III and one patient (16.67%) had classification IV. Compared with Cormack and Lehane classification system as the gold standard for difficult intubation, the sensitivity and specificity of MMT was 66.67% and 96.97% respectively, while ULBT had a sensitivity of 77.78% and a specificity of 93.18%, and TMD had a sensitivity of 55.56% and specificity of 94.97% respectively. A combination of different tests improved their efficiencies. The sensitivity and specificity MMT and TMD combinations was 77.78% and 92.42% respectively, while it was 88.89% and 93.18%, respectively for MMT and ULPT. The combination of TMD and ULBT has a sensitivity of 88.33% and a specificity of 91.67%. Conclusions: Upper lip biting test has the best sensitivity while MMT had the best specificity. No single test alone can be reliable for predicting of difficult intubation. The combination of ULBT and MMT was the best in terms of both sensitivity and specificity for prediction of difficult intubation.

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ATIF, MUHAMMAD, MUHAMMAD ABDULLAH, MUHAMMAD JAVAD YOUSAF, and Khalid Buland. "ACCURACY OF THE UPPER LIP BITE TEST;." Professional Medical Journal 20, no. 01 (2012): 132–38. http://dx.doi.org/10.29309/tpmj/2013.20.01.589.

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Objective: To compare the accuracy of Upper lip bite test with modified Mallampati classification for predicting the difficultlaryngoscopic intubation. Study Design: Cross sectional Study. Place and duration of study: The study was carried out at Department ofAnaesthesiology, Intensive Care and Pain management, Combined Military hospital, Rawalpindi from September 2008 to August 2009.Patients and Methods: Four hundred patients undergoing elective surgery meeting the inclusion/exclusion criteria were enrolled afterwritten informed consent. The airways of the patients were evaluated by using the modified Mallampati classification (MMP) and theUpper lip bite test (ULBT). MMP class 3 or 4 and ULBT class 3 were considered as indicators of difficult intubation. The laryngeal view wasgraded by Cormack and Lehane classification (Gold standard). Grade 1 or 2 was considered to represent easy intubation and grade 3 or 4to represent difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy werecalculated for both the tests separately by using the 2×2 table. Results: ULBT had a higher accuracy of 94%, specificity of 99.2% andpositive predictive value 70% compared to MMP accuracy of 82.7%, specificity of 84.4% and positive predictive value of 22.7%.Conclusions: The diagnostic accuracy of the Upper lip bite test was more than the modified Mallampati classification. We suggest that itbe compared with the other prevailing tests as well which are often used to assess difficult intubations.

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Thomas, Monish, and Nichelle M. Saldanha. "Comparison of Upper Lip Bite Test with Modified Mallampati Score in Predicting Difficult Intubation." International Journal of Science and Healthcare Research 7, no. 1 (2022): 1–8. http://dx.doi.org/10.52403/ijshr.20220101.

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Background and Aims: Identifying a patient with a difficult airway is important in planning anaesthetic management so that endotracheal intubation can be achieved safely. This study aims to compare modified Mallampati score with Upper Lip Bite Test to predict difficult intubation using intubation difficulty scale. Materials and methods: A prospective study was carried on 104 patients, both sexes aged between 18 to 60 years scheduled for elective surgeries under general anaesthesia fulfilling inclusion and exclusion criteria. Patient airway was evaluated by MMT and ULBT preoperatively. Predictors of difficult endotracheal intubation were assigned to MMT class III and IV, ULBT class III. After premedication and induction laryngoscopy was performed. After successful intubation Intubation difficulty score was noted down based on the sum of seven assessing parameters. A score >5 was considered difficult intubation. Results: The incidence of difficult intubation in the study was 10.6% (i.e. 11 out of 104 patients). In this study ULBT had a higher sensitivity (90.9% v/s 18.20%), specificity (95.7% v/s 75.3%) PPV (71.4% v/s 8%) and NPV (98.9% v/s 88.6%) than that of MMT Conclusion: Upper lip bite test is better at predicting difficult intubation with higher accuracy when compared to Modified Mallampati test. Both the tests are good predictors of easy intubation. Keywords: Upper Lip Bite Test (ULBT), Modified Mallampati test (MMT), Intubation Difficulty scale (IDS), airway assessment. Difficult intubation prediction, Difficult airway

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Maji, Chaity. "Difficult airway Assessment: Comparison of Upper Lip Bite Test (ULBT) and Modified Mallampati Test (MMT)." Indian Journal of Anesthesia and Analgesia 4, no. 4 (Part-1) (2017): 969–73. http://dx.doi.org/10.21088/ijaa.2349.8471.4417.9.

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F, Javaher Foroosh Zadeh, and Safaii Sara. "Comparison of four methods for predicting difficult intubation." International Journal of Bioassays 5, no. 01 (2016): 4720. http://dx.doi.org/10.21746/ijbio.2016.01.005.

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Confirmation of endotracheal tube appointment is of critical importance, since unrecognized esophageal intubation can be rapidly lethal (death, brain damage). The aim of our study was to compare four different methods for prediction of difficult intubation: Mallampati, Thyro-mental distance, ULBT (Upper Lip Bite Test), and Inter incisicor gap. In a prospective study, 448 patients with a mean age of 53.5 who were scheduled for elective surgery were selected randomly and enrolled. Before induction of anesthesia, the airways were assessed by Mallampati test, Thyro mental distance, Upper lip bit test(ULBT) and Inter incisor gap. Laryngoscopic view according to the Cormack and Lehane grading system was determined after induction of anesthesia and Grades 3 and 4 defined as “difficult intubation.” Degree of observed difficulty of intubation was compared to predicted values. Sensitivity, specificity, positive and negative predictive values and accuracy of these tests and their combinations with the ULBT were calculated. Statistical analysis was performed using SPSS version 16. Data were analysis by using Fishers exact and McNemar's test, and a Pvalue. <0.05 was considered statistically significant. The prevalence of difficult intubation Cormack-Lehane in this study was 8.4%, Mallampati test had the highest sensitivity (47.3%) and Thyro-mental distance was most specific (96%). The ULBT (upper lip bite tests) had most positive and negative predictive value (37.9% & 93. 5%).Data also showed that power of these tests in predicting easy intubation is more than their ability in assessing the likelihood of difficult intubation. There was no significant difference regarding difficult intubation based on gender (P < 0.05), whereas there were significant differences between the older tests and laryngeal view (P < 0.05, Mc-Nemar test). Despite the validity of MMP, TMD, ULBT and IIG in predicting easy intubation is much greater than the value in prediction of difficult intubation; however, the simplicity of performing these tests and results of the four tests in evaluating patients before surgery by combination of tests in predicting difficult intubation will likely safe. It seems that best results are from applying combined test than a single one.

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Gauchan, Sabin, Chitra Thapa, Sulav Acharya, and Sanam Dangol. "A comparison of ratio of patient’s height to thyromental distance with modified mallampati test and upper lip bite test for prediction of difficult laryngoscopy." Nepal Medical College Journal 25, no. 4 (2023): 335–40. http://dx.doi.org/10.3126/nmcj.v25i4.60923.

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Various airway evaluation tests are performed to predict difficult intubation. The ratio of Height to thyromental distance has been reported to have a good predictability. This study tested the performance of ratio of height to thyromental distance and compared it with commonly performed airway evaluation tests: the modified Mallampati test and upper lip bite test. This descriptive study was conducted in 120 patients presenting for surgery under general anesthesia with endotracheal intubation. Preoperative airway assessment was done using Modified Mallampati test, upper lip bite test and ratio of height to thyromental distance. The Cormack and Lehane grading was done during laryngoscopy to determine easy or difficult visualization of larynx. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of three tests were calculated. Difficult laryngoscopy was seen in 9 patients (7.5%). The sensitivity, specificity, positive predictive value, negative predictive value respectively for the tests were modified Mallampati test (22.2%, 89.2%, 14.3% and 93.4%), upper lip bite test (22.2%, 100%, 100% and 94.1%), ratio of height to thyromental distance (77.8%, 95.5%, 58.3% and 94.16%). In conclusion, we found that the ratio of patient’s height to thyromental distance performed better than MMT and ULBT in predicting difficult visualization of larynx in our population.

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Kaur, R., MT Zeya, and M. Panditrao. "A Study to Evaluate Ease of Laryngoscopy and Intubation by Use of Upper Lip Bite Test, Modified Mallampati Classification and Thyromental Distance." International Journal of Pharmaceutical and Clinical Research 16, no. 8 (2024): 1827–34. https://doi.org/10.5281/zenodo.13883845.

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Background: The occurrence of difficult intubation during general anesthesia ranges between 1% and 18%, while the rate of intubation failure is estimated to be around 0.05% to 0.35%. Various methods have been employed to predict difficult laryngoscopy, but consistent validation across different populations is essential for any test to become a standard practice. The Upper Lip Bite Test (ULBT) has shown potential in its initial studies, but requires further validation. In this study, we compared the ULBT, Modified Mallampati Classification (MMC), and Thyromental Distance (TMD), both individually and in combination, to determine which tests are most significantly associated with difficult glottic exposure. Methods: Following approval from the institutional ethics committee, we included 402 adult patients (ASA I and II) scheduled for elective surgeries requiring endotracheal intubation. Preoperatively, all patients underwent ULBT, MMC, and TMD assessments, and their glottic exposure was classified using the Cormack-Lehane scale during intubation. We analyzed the sensitivity, specificity, positive predictive value, and negative predictive value of each test to compare their effectiveness. Results: The study found that 11.4% of patients experienced difficult laryngoscopy, with a 0.49% rate of intubation failure. When used individually, none of the three tests demonstrated strong predictive ability. However, combining the tests provided an incremental increase in diagnostic accuracy. Conclusion: Our findings suggest that ULBT, MMC, and TMD, when used alone, have only limited ability to predict difficult intubation. However, combining these tests offers improved diagnostic value, though still not definitive. Further research is needed to develop more reliable screening methods for predicting difficult intubation.

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Dr., Sushmita S. Sumer, Soma C. Cham Dr., Amrusha M. Raipure Dr., and P.G. Dhumane Dr. "Evaluation of difficult airway in paediatric population ranging from 5-12 years age group." International Journal of Medical Research and Review 7, no. 5 (2019): 411–21. https://doi.org/10.17511/ijmrr.2019.i05.10.

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Background: The aim of this study is to predict difficult airway on the basis of various airway assessment parameter in the paediatric population between 5-12 years age group. To assess the value of modified Mallampati test (MMT), upper-lip-bite test (ULBT), thyromental distance (TMD), ratio of height to thyromental distance (RHTMD) from which Cormack Lehane grade was derived to predict difficult airway i.e. difficult intubation in paediatric patients ranging from 5-12 years age. Material and Methods: 100 ASA grade I & II paediatric patients of either sex between the age group of 5-12 years posted for elective surgery under general anaesthesia requiring endotracheal intubation were included in the study. Modified Mallampati test, upper lip bite test, thyromental distance and ratio of height to thyromental distance of the patients were measured and recorded. All the distances were measured with the help of a flexible measuring tape so as to measure the distances accurately. Results: Modified Mallampati test has the highest sensitivity (75%) and specificity (92.05%) among all the other screening tests. It also has high positive predictive value (56.25%), negative predictive value (96.43%) and diagnostic accuracy (90%). Upper Lip Bite test has high specificity (79.55%) and negative predictive value (93.33%) with high diagnostic accuracy (77%). It has a sensitivity of 58.33% which is similar to the sensitivity of thyromental distance and ratio of height to thyromental distance. Thyromental distance has high specificity (65.90%) with high negative predictive value (92.06%). Conclusion: Modified Mallampati test is a useful bedside screening test for predicting difficult intubation in patients between 5-12 years age group. The Upper Lip bite test and thyromental distance has high specificity with high negative predictive value and diagnostic accuracy. The ratio of height to thyromental distance is least useful predictor of airway assessment.

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Qamar, Kiran, Sheikh Ziarat Ali, Saba Naveed, Mehtab Tipu Chaudary, Fariha Aslam, and Nazia Rubab Maqbool. "Positive Predictive Value of Upper Lip Bite Test in Predicting Difficult Intubation." Pakistan Journal of Medical and Health Sciences 16, no. 4 (2022): 326–29. http://dx.doi.org/10.53350/pjmhs22164326.

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Objective: To determine the positive predictive value of upper lip bite test in predicting difficult intubation by taking Cormack and Lehane classification as gold standard. Design of the Study: Cross sectional study. Study Settings: This cross-sectional study was conducted at Department of Anesthesiology, Sir Ganga Ram Hospital, Lahore from 04/06/2021 to 03/12/2021. Materials and Methods: This study involved 313 patients of both genders, aged between 18-70 years undergoing general anesthesia on elective lists having positive upper lip bite test (Grade-III). On the basis of Cormack and Lehane Classification, the diagnosis was verified. Results of the ULBT were compared to the Cormack and Lehane grade-III and grade-IV diagnoses. Every patient's written informed permission was obtained. Results: In The mean age of the patients was 43.78±12.32 years. Majority (n=150, 47.9%) of the patients were aged between 36-52 years. There were 198 (63.3%) male and 115 (36.7%) female patients in the study group. Among the procedures, herniorrhaphy (32.9%) and cholecystectomy (26.8%) were the more frequent procedures followed by thyroidectomy (17.6%), tonsillectomy (13.1%) and mastectomy (9.6%). Majority (42.8%) of the patients belonged to ASA Class-I followed by ASA Class-II (29.7%) and ASA Class-III (27.5%). Difficult intubation was confirmed in 232 (74.1%) patients on Cormack and Lehane Classification (as per operational definition). Thus there were 232 true positive patients with 81 false positive patients. With the gold standard Cormack and Lehane Classification, the upper lip bite test yielded a positive predictive value of 74.1 percent in the prediction of difficult intubation. Conclusion: According to the gold standard of Cormack and Lehane Classification, an upper lip bite test (Grade-III) has a 74.1 percent positive predictive value for difficult intubation in patients undergoing general anaesthesia with endotracheal intubation on the elective list. Keywords: Difficult Intubation, Cormack and Lehane Classification, Upper Lip Bite Test

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Thayyil, Baseema, Neetha Thattaparambil Chandran, Asish Karthik, and Maya Gomathy Amma. "Comparison of Upper Lip Bite Test and Ratio of Height to Thyromental Distance in Predicting Difficult Tracheal Intubation in South Indian Population – A Descriptive Study." Journal of Evidence Based Medicine and Healthcare 8, no. 27 (2021): 2412–16. http://dx.doi.org/10.18410/jebmh/2021/447.

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BACKGROUND Failure in managing the airway is the most important cause of death in patients undergoing general anaesthesia (GA). For effectively preventing airway catastrophe it is essential to have a meticulous airway assessment pre-operatively. Many methods are in use to predict difficult airway like Mallampati, Wilson’s scoring, percentage of glottic opening (POGO) scoring, Cormack - Lehane classification, thyromental distance, mandibular hyoid distance, atlantooccipital joint extension etc. In this study, we compared between two popular methods of airway assessment, upper lip bite test (ULBT) and height to thyromental distance ratio (RHTMD) to predict the difficulty in tracheal intubation. METHODS This descriptive study was conducted at Government Medical college, Thrissur, over a period of one year , on 76 patients of American society of Anaesthesiologist (ASA) - PS l - lll, requiring general anaesthesia. ULBT and RHTMD were used to assess the patient’s airway. It was correlated with Cormack - Lehane classification during direct laryngoscopy. The data was analysed using Fisher exact test (P < 0.05) and Kappa statistics. RESULTS Out of the 76 patients, 41 (53.9%) were women 35 were men (46.1 %). ULBT predicted 89.6 % [25 + 43] belonging to class 1 and 2 as easy, while 10.5 % [8] of class 3 as difficult. RHTMD predicted 35 patients (46 %) as easy (grade 1) and 41 patients (54 %) as grade 2. Using ULBT, of the 8 patients predicted to have difficult intubation (Class 3), 2 were found practically difficult and 6 were easy. In remaining 68 patients, 23 patients had difficult view and 45 had easy view. According to Cormac and Lehane, among 41 patients who predicted difficult by RHTMD, 19 patients were practically difficult and 22 were easy. Of 35 patients, 6 patients were difficult and 29 were easy. CONCLUSIONS The RHTMD is more sensitive compared to ULBT in predicting difficult intubation. As assessed by Cormack - Lehane classification. KEYWORDS Difficult Intubation, Ratio of Height to Thyromental Distance, Upper Lip Bite Test

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Das, Sunil Kumar, and Gaurav Mahato. "Difficult airway management in an emergency in Nepal." Journal of General Practice and Emergency Medicine of Nepal 9, no. 13 (2022): 40–44. http://dx.doi.org/10.59284/jgpeman45.

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Introduction: Health care provider often face challenges in managing airway in-patients in emergency department having respiratory compromise. Here in this review, we have discussed advances in management of difficult airway in emergency setting in Nepal. Method: Articles available n google scholar with key word “ airway management’’, “difficult airway” , “ emergency” , “failed intubation”, “ Nepal” were retrieved. Amongst which 14 articles were retrieved for the discussion. Result: MMT was better for predicting difficult laryngoscopy when compared to measurement of sternomental, thyromental and inter-incisor distances and grading of mandibular protrusion. Similarly when comparing upper lip bite test to MMT, ULBT has better sensitivity and specificity. laryngoscopic view with 5 cm of head elevation had a better visualization. Conclusion: The available evidence recommend using upper lip bite test in emergency setting with comparison to modified / mallampati classification. Different tests can be used in accordance to urgency of intervention. Similarly, head elevation of 5 cm can be routinely practiced for better visualization during laryngoscopy.

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V Chavan, Rashmee, and Madhurima Sinharay. "Predicting difficult intubation: A comparison between upper lip bite test (ULBT) and Modified Mallampati test (MMT)." Indian Journal of Clinical Anaesthesia 6, no. 4 (2019): 601–6. http://dx.doi.org/10.18231/j.ijca.2019.117.

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S, Nishana, Gopakumar G, Prathibha K, Ranju Jayaprakash, and George George. "Analysis of various airway evaluation tests to prognosticate difficult endotracheal intubation." National Journal of Physiology, Pharmacy and Pharmacology 13, no. 8 (2023): 1. http://dx.doi.org/10.5455/njppp.2023.13.06315202326062023.

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Background: Unanticipated difficult intubation or failure of intubation is a major source for anesthesia associated deaths. Hence pre-anesthetic checkup should include a detailed airway evaluation to foresee difficult endotracheal intubation. Some easy bedside tests to predict difficult airway include modified Mallampati test (MMT), ratio of height to thyromental distance (RHTMD), and upper lip bite test (ULBT). Actual difficulty of airway can be estimated using Cormack Lehane (CL) grading while performing laryngoscopy. Combination of two or more bedside clinical tests is used to identify difficult airway and act accordingly. Aims and Objectives: We aimed at identifying those airway assessment tests which best predicted difficult airway. The objectives were to determine the agreement between MMT, RHTMD, ULBT with CL grading, and also the agreement between MMT and ULBT, MMT and RHTMD. Materials and Methods: This observational research was done in 88 individuals between 18 and 75 years planned for elective procedures requiring endotracheal intubation as a part of general anesthesia. The clinical assessment tests such as ULBT, RHTMD, and MMT were done on eligible participants during pre-anesthetic check-up. In the operation theater, patient was prepared, premedicated, and induced. CL grading was used to assess the laryngoscopic view. We tried to determine the agreement between MMT, ULBT and RHTMD with CL grading. We also tried to determine the agreement between MMT and ULBT., MMT and RHTMD. Results: MMT showed moderate, RHTMD showed slight, and ULBT showed no agreement with CL grading. MMT showed highest sensitivity and RHTMD showed highest specificity. No agreement was found for ULBT and RHTMD with MMT. Conclusion: MMT and RHTMD can be used in predicting difficult airway access; out of which MMT is better than RHTMD. ULBT is not an ideal test to identify difficult endotracheal intubation. Laryngoscopic view becomes difficult with increase in weight and age.

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Lim, Wan Yen, Sharon Gek Kim Ong, Jia Xin Chai, Rhommela Garis Duran, Ahmad Hamidi Mohammed Ali, and John Ong. "The Evaluation and Modification of Standard Airway Assessment Tests for Virtual Anaesthetic Assessments: A Pilot Study." Journal of Clinical Medicine 14, no. 2 (2025): 342. https://doi.org/10.3390/jcm14020342.

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Background/Objectives: Virtual preoperative anaesthetic assessments can significantly reduce healthcare costs and improve patient convenience. The challenge with virtual consults is often the airway assessments, which screen for potentially difficult airways (PDAs). The objective of this pilot study was to determine the reliability of standard airway screening tests for detecting PDAs when conducted virtually. Methods: An observational longitudinal study was conducted between July 2021 and April 2022 at a tertiary hospital in Singapore. We compared the Mallampati score (MS), upper lip bite test (ULBT), thyromental distance, mouth opening test, and neck movements in 94 patients, first during virtual assessments before surgery and subsequently at face-to-face preoperative assessments (gold standard) on the day of surgery by the same team of anaesthesiology trainees. Goodman and Kruskal’s gamma coefficient measured concordance between virtual and face-to-face assessment results. Logistic regression (LR) identified virtual predictors of PDAs in clinical practice. AUROC values informed tool performance. Results: LR showed that elevated virtual MS, virtual ULBT, and body mass index (BMI) were potential predictors of clinical PDAs. Termed the “MBBS”, this collective score showed good performance with a sensitivity of 95% and an AUROC of 0.79. Importantly, all screening tests performed poorly in virtual assessments when applied individually (sensitivity < 50%). Conclusions: In this pilot study, BMI combined with MS and ULBT could reliably detect PDAs during virtual airway assessments. The data herein support further large multi-centre studies to validate the MBBS for clinical use.

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Niranjana, P.S., R. Chandran Nanna, and Thomas Sanjith. "Ratio of Patient's Height to Sternomental Distance in Assessing Difficult Laryngoscopy among Adults Scheduled for Elective Surgery." International Journal of Toxicological and Pharmacological Research 13, no. 9 (2023): 188–95. https://doi.org/10.5281/zenodo.11081787.

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Background: Failure to assess and predict difficulty in airway management can contribute to poor outcomes in anesthesiology practice. The existing parameters are far from perfect. Ratio of height to sternomental distance as a tool to predict difficult laryngoscopy requires further validation. Methods: This was a hospital based prospective observational study conducted among 300 adult patients undergoing general anaesthesia for elective surgery. Modified Mallampati test (MMT), Upper lip bite test (ULBT), sternomental distance (SMD) and ratio of height to sternomental distance (RHSMD) were assessed preoperatively. Difficulty in laryngoscopy was assessed using Cormack -Lehane grading. The sensitivity, specificity, predictive values and accuracy of each test for predicting difficult laryngoscopy (i.e., CL grade III and IV) were compared. The best cut off of RHSMD was determined by receiver operating characteristic curve (ROC) analysis.  This was done in the Department of Anaesthesiology, Government T.D. Medical College, Alappuzha from January 2019 to June 2021 after obtaining Institutional Ethics Committee approval. Results: The incidence of difficult laryngoscopy was 8.7%. There were no difficult intubations. RHSMD was independent of age and gender. The area under the ROC curve for RHSMD was 0.89 (95% confidence interval 0.83-0.96). The best cut-off was 11.9. RHSMD>11.9 (OR=19.5), ULBT class 3 (OR=15.5) and MMT class above 2 (OR=9.2) were independently associated with difficult laryngoscopy. The sensitivity and the specificity of predicting difficult laryngoscopy were 65.4% & 86.9% for MMT, 15.4% & 99.6% for ULBT, 42.3% & 93.8% for SMD at cut off of 12.5cm, 73.08% & 92.3% for RHSMD at cut off of 11.9 and 92.3% & 81.39% for combination of MMT, ULBT and RHSMD. Conclusion: RHSMD is an accurate tool for predicting difficult laryngoscopy.  It is a better screening test for difficult laryngoscopy compared to ULBT, MMT and SMD. However, a combination of multiple tests is recommended to improve the accuracy of the prediction of difficult laryngoscopy.

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Jaskiran, Kaur, K. Osahan Narjeet, Kaur Navkiran, George Christina, and Singh Gobinder. "To Assess the Ratio of Height to Thyromental Distance as a Predictor of Difficult Laryngoscopy." International Journal of Pharmaceutical and Clinical Research 16, no. 5 (2024): 469–76. https://doi.org/10.5281/zenodo.11403578.

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Background and Aim: Unanticipated difficult airway and its associated morbidity can be avoided by using airway assessment tests preoperatively, in isolation or in combination. The aim of this present study was to assess the Ratio of height to thyromental distance (RHTMD) as a predictor of difficult laryngoscopy and to compare it with other indices like Modified Mallampati Test (MMT), Thyromental distance (TMD) and Upper lip bite test (ULBT). Material and Methods: This study was conducted on 215 patients scheduled for elective surgery under general anaesthesia needing endotracheal intubation. Airway was assessed preoperatively using MMT, ULBT, TMD and RHTMD. Intraoperatively, Cormack and Lehane’s classification was used to assess and grade difficult laryngoscopy. Data was analysed using SPSS version 26.0. Results: The incidence of difficult laryngoscopy in our study was 11.16%. RHTMD emerged as the best predictor with the maximum area under curve (AUC = 0.83). Of the four indices, RHTMD was found to have the highest sensitivity (91.67%), positive predictive value (30.99%) and negative predictive value(98.61%) compared to other indices. Conclusion: RHTMD emerged as the single best predictor of difficult laryngoscopy with maximum area under curve (AUC = 0.83). Predictability of difficult airway can be enhanced by combining it with other tests.

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Patel, Jenish. "Comparison of the Upper Lip Bite Test (ULBT) with the Ratio of Height to Thyromental Distance (RHTMD) for the Prediction of Difficult Laryngoscopy in Apparently Normal Patients." Indian Journal of Anesthesia and Analgesia 7, no. 2 (2020): 488–92. http://dx.doi.org/10.21088/ijaa.2349.8471.7220.7.

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Poudel, Deepak, Kumud Pyakurel, Birendra Prasad Sah, Anuja Pokhrel, Kanak Khanal, and Lalit K. Rajbanshi. "Comparison between clinical and ultrasonographic parameters in predicting difficult airway: An observational prospective study." Birat Journal of Health Sciences 8, no. 2 (2023): 2039–44. http://dx.doi.org/10.3126/bjhs.v8i2.59856.

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Introduction : Various clinical tests are applied at the bedside to predict difficult airway during the pre-anaesthetic examination. Ultrasonography can be used to evaluate the airway and predict difficulty in laryngoscopy and endotracheal intubation. Objective : To compare the various clinical and ultrasonographic parameters in predicting difficult airway. Methodology: This prospective observational study was carried out at Birat Medical College and Teaching Hospital. The clinical parameters obtained were Modified Mallampati Grade (MMP), Upper Lip Bite Test (ULBT) and Thyromental Distance (TMD) and the ultrasonographic (USG) parameters used were Tongue Volume (TV), Hyomental Distance Ratio (HMDR) and distance of soft tissue from skin to hyoid bone (DSHB).These results were correlated with Cormack-Lehane (CL) grade during laryngoscopy of 200 patients. The sensitivity, specificity, Receiver Operating Characteristic (ROC) curve along with Area under the curve (AUC) was calculated for each parameter. Result: Incidence of difficult airway was 15.5%. The sensitivity and specificity of ultrasonographic tongue volume (TV) was higher among all parameters in predicting difficult airway. The specificity of HMDR and DSHB were better compared to clinical parameters. Conclusion: The use of ultrasound in pre-anaesthetic examination can be a viable tool along with clinical parameters for prediction of difficult airway.

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Hrishi, Ajay Prasad, Unnikrishnan Prathapadas, Ranganatha Praveen, Smita Vimala, and Manikandan Sethuraman. "A Comparative Study to Evaluate the Efficacy of Virtual Versus Direct Airway Assessment in the Preoperative Period in Patients Presenting for Neurosurgery: A Quest for Safer Preoperative Practice in Neuroanesthesia in the Backdrop of the COVID-19 Pandemic!" Journal of Neurosciences in Rural Practice 12, no. 04 (2021): 718–25. http://dx.doi.org/10.1055/s-0041-1735824.

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Abstract Objectives Neurosurgical patients with cervical spine pathologies, craniofacial and craniovertebral junction anomalies, recurrent cervical spine, and posterior fossa surgeries frequently present with an airway that is anticipated to be difficult. Although the routine physical evaluation is nonaerosol-generating, Mallampati scoring, mouth opening, and assessment of lower cranial nerve function could potentially generate aerosols, imposing a greater risk of acquiring severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection. Moreover, airway evaluation requires the patient to remove the mask, thereby posing a greater risk to the assessing anesthesiologist. Thus, we designed this study to evaluate the efficacy of virtual airway assessment (VAA) done via telemedicine in comparison to direct airway assessment (DAA), and assess the feasibility of VAA as a part of the preanesthetic evaluation (PAE) of patients presenting for neurosurgery in the backdrop of the COVID-19 pandemic. Materials and Methods A total of 55 patients presenting for elective neurosurgical procedures were recruited in this prospective, observational study. The preoperative assessment of the airway was first done by a remote anesthetist via an encrypted video call, using a smartphone which served the purpose of telemedicine equipment, followed by a direct assessment by the attending anesthetist. The following parameters were assessed: mouth opening (MO), presence of any anomalies of tongue and palate, Mallampati classification (MPC) grading, thyromental distance (TMD), upper lip bite test (ULBT), neck movements, and Look-Evaluate-Mallampati-Obstruction-Neck mobility (LEMON) scoring system. Statistical Analysis Demographic parameters were expressed as mean ± SD. Agreement between the values obtained by VAA and DAA parameters were analyzed with the Kappa test. Results We observed a “perfect agreement” between the DAA and VAA with regard to MO. Assessment of ULBT, neck movements, and the LEMON score had an overall “almost perfect agreement” between the DAA and VAA. We also observed a “substantial agreement” between VAA and DAA during the assessment of MPC grading and TMD. Conclusion Our study shows that PAE and VAA via telemedicine can reliably be used as an alternative to direct physical preanesthetic consultation in the COVID-19 scenario. This could reduce unnecessary exposure of anesthesiologists to potential asymptomatic COVID-positive patients, thereby protecting the available skilled workforce, without any significant compromise to patient care.

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Wu, Huihui, and Hong Wang. "Diagnostic Efficacy and Clinical Value of Ultrasonography in Difficult Airway Assessment: Based on a Prospective Cohort Study." Contrast Media & Molecular Imaging 2022 (August 24, 2022): 1–11. http://dx.doi.org/10.1155/2022/4706438.

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Objective. A case-control study was conducted to explore the diagnostic efficacy and clinical value of ultrasound in difficult airway assessment. Methods. A total of 220 patients undergoing elective surgery under general anesthesia were prospectively enrolled in our hospital from April 2018 to April 2021. General data were collected one day before operation, including sex, age, height, weight, body mass index (BMI), modified Mallampati test (MMT), inter-incisor distance (IID) and thyromental distance (TMD), the upper lip bite test (ULBT), and thyromental height (TMH). DSH, DSE, DSV, HMD, and tongue width and thickness were measured by ultrasound in the supine position before anesthesia induction on the day of operation. The above data were measured by the same anesthesiologist. After anesthesia, the patients were exposed to laryngoscope by the same senior doctor who did not participate in the data analysis, and the Cormack–Lehane (CL) grade was recorded and endotracheal intubation was completed. The relationship between DSE, DSH, DSV, HMD, and tongue width and thickness and laryngoscope exposure difficulty and tracheal intubation difficulty was analyzed. The critical value of each index for predicting laryngoscope exposure difficulty and tracheal intubation difficulty was obtained by the receiver operating characteristic curve (ROC) and Jordan index. According to the critical value, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of each index were calculated. Results. On comparing the general conditions of the four groups, this study prospectively included 220 patients undergoing elective surgery under general anesthesia for tracheal intubation in our hospital from April 2018 to April 2021, of which 8 cases were excluded from the study because of loss of incisors, 5 cases were excluded from the study due to unclear development of the anterior vocal cords under ultrasound, 7 cases were excluded from the study, and finally 200 patients were included in the study, including 104 males and 96 females. Among the 200 patients, difficult laryngoscope exposure was found in 26 cases (13.00%) and difficult tracheal intubation in 17 cases (8.50%). Tracheal intubation was performed in 17 patients with a visual laryngoscope and light rod, respectively. The weight and BMI of patients in the DL group were higher than in the NDL group, and the difference was statistically significant ( P < 0.05 ); the weight and BMI of patients in the DI group were higher than in the NDI group, and the difference was statistically significant ( P < 0.05 ); there was no significant difference in sex, age, and height between the DL group and the NDL group and the DI group and the NDI group ( P > 0.05 ). Compared with the NDL group, IID, TMD, and TMH in the DL group were lower, and the difference was statistically significant ( P < 0.05 ); there was no significant difference in ULBT ( P > 0.05 ). DSE, DSH, and DSV were higher than in the NDL group, and the difference was statistically significant ( P < 0.05 ), the HMD was lower than in the NDL group, and the difference was statistically significant ( P < 0.05 );the width and thickness of tongue were higher than in the NDL group, and the difference was statistically significant ( P < 0.05 ). On comparing the DI NDI groups, the IID, TMD, and TMH in group DI were lower than in group NDI, and the difference was statistically significant ( P < 0.05 ), but there was no significant difference in ULBT ( P > 0.05 ); DSE, DSH, and DSV were higher than in the NDI group, and the difference was statistically significant ( P < 0.05 ); the HMD was lower than in the NDI group, and the difference was statistically significant ( P < 0.05 ); the width and thickness of tongue were higher than in the NDL group, and the difference was statistically significant ( P < 0.05 ). The AUC of BMI, TMH, DSE, DSV, HMD, and tongue width and thickness all ranged from 0.70 to 0.9. Laryngoscope exposure difficulty diagnostic value was medium. The AUC of TMD, MMT, ULBT, IID, and DSH ranged from 0.5 to 0.7. The diagnostic value of laryngoscope exposure difficulty was low. According to the ROC curve, the AUC value of HMD, DSE, and tongue thickness in ultrasonic indicators was higher than that of traditional indicators and the AUC value of TMH was the highest in traditional indicators. When the HMD cutoff value was 5.29 cm; the accuracy, sensitivity, specificity, PPV, and NPV were 73.6%, 96.7%, 71.6%, 31.8%, and 97.4%, respectively. Compared with tongue width, tongue thickness has a better predictive performance. The accuracy of DSH, DSV, DSE, and tongue width and thickness in predicting difficult laryngoscope exposure was lower than HMD and the difference was statistically significant ( P < 0.05 ). The patients in the DI and NDI groups indicated that the AUC of ULBT, TMD, and IID was between 0.5 and 0.7, the diagnostic values of BMI, MMT, TMH, DSE, DSH, DSV, HMD, and tongue width and thickness were between 0.7 and0.9, and the diagnostic value for tracheal intubation difficulty was moderate. According to the ROC curve, HMD, DSE, and tongue thickness in ultrasonic indexes were higher compared to traditional indexes. Among the traditional indexes, the AUC value of TMH is the largest. In ultrasonic indexes, when the critical value of HMD DSE is 4.85 cm, the AUC value is 0.893, and its accuracy, sensitivity, specificity, PPV, and NPV are 81.6%, 93.8%, 80.6%, 30.2%, and 99.5%, respectively. In ultrasonic indexes, the prediction performance is better, followed by the tongue thickness prediction performance. The accuracy of DSH, DSV, DSE, and tongue width and thickness in predicting difficult tracheal intubation was lower than in HMD, and the difference was statistically significant ( P < 0.05 ). Conclusion. Ultrasonic measurements such as DSH, DSE, DSV, HMD, and tongue width and thickness have predictive value for difficult airway;when the ultrasonic measurement of HMD is ˂5.29 cm, we should pay attention to the difficulty of laryngoscope exposure, and when DSE is ˂4.85 cm, we should watch out for difficult tracheal intubation. In terms of other ultrasound indexes, HMD is more valuable in predicting difficult airway.

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Devkota, Kriti, and Kiran Adhikari. "COMPARISON OF UPPER LIP BITE TEST AND MODIFIED MALLAMPATI TEST FOR PREDICTION OF DIFFICULT INTUBATION." Journal of Chitwan Medical College 11, no. 2 (2021): 3–6. http://dx.doi.org/10.54530/jcmc.331.

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Background: Insertion of endotracheal tube is the basic skill acquired by all anesthesiologists. An unanticipated difficult intubation can be catastrophic and is one of the major causes of morbidity and mortality in anesthetic practice. So, there are multiple screening tests designed to correctly predict difficult intubation but none of them are 100 % accurate. The study aimed to compare the Modified Mallampatti test with Upper Lip Bite test for correct prediction of difficult intubation. Methods: A cross-sectional study was conducted in the College of Medical Sciences, Bharatpur from 16th June 2020 to December 31st 2020. A total of 610 patients requiring general anesthesia with endotracheal intubation were included in the study. The Modified Mallampatti test and Upper Lip Bite test along with laryngoscopy was performed by an experienced anesthesiologist. Sensitivity, specificity, accuracy and positive and negative predictive values for both tests were calculated and compared. Results: The incidence of difficult intubation was 17.7% in our study. The upper lip bite test showed better sensitivity (79.63% vs 37.96%), specificity (93.82% vs 69.92%), positive predictive value (73.5% vs 21.35%), negative predictive value (95.53% vs 83.97%) and accuracy (91.31% vs 64.26%) compared to Modified Mallampatti test Conclusions: Upper lip bite test was a better predictor of difficult intubation compared to MMT with higher accuracy and predictive values.

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Saeed, Muhammad Tayyab, Ali Rao, Muhammad Nasir Saeed, Tasneem Alam, Azmat Riaz, and Hira Ahmad. "Comparison of Upper Lip Bite Test and Thyromental Distance with Other Airway (Malampatti and Inter Incisor Distance) Assessment Tests for Predicting Difficult Endotracheal Intubation." Pakistan Armed Forces Medical Journal 74, no. 5 (2024): 1281–84. http://dx.doi.org/10.51253/pafmj.v74i5.8112.

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Objective: To study the ability of upper lip bite test and thyromental distance to predict difficult endotracheal intubation when compared to standard assessment tests such as Mallampati and inter incisor distance. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Anesthesiology, Pak-Emirates Military Hospital, Rawalpindi, Pakistan, Sep 2020 to Mar 2021. Methodology: We studied a total of 50 patients who reported for the administration of general anesthesia. All patients underwent evaluation with modified Mallampati test, upper lip bite test and thyromental distance test. All participants underwent subsequent intubation according to a standard protocol. The researcher documented difficult intubations. Results: We found the upper lip bite test to have a sensitivity of 75.7%, a specificity of 84.2%, and a diagnostic accuracy of 78.6%. Thyromental distance had a sensitivity, specificity, and diagnostic accuracy of 51.4%, 78.9% and 60.7%, respectively while the modified Mallampati had a sensitivity of 64.9%, 89.5%, specificity and a diagnostic accuracy of 73.2%. Conclusion: Upper lip bite test is a useful bedside assessment tool with which to predict the probability of a difficult endotracheal intubation. Height to thyromental distance ratio test is also acceptable for rapid assessment.

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Sethi, Priyanka, and Neeraj Gupta. "Does upper lip bite test predict difficult intubation?" Indian Journal of Anaesthesia 58, no. 4 (2014): 509. http://dx.doi.org/10.4103/0019-5049.139038.

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López, S. Gadín, E. Sánchez Pérez, B. Gutiérrez Tonal, F. De La Gala, and A. Alonso Chico. "Predicting difficult airway: The upper lip bite test." European Journal of Anaesthesiology 25, Sup 44 (2008): 246. http://dx.doi.org/10.1097/00003643-200805001-00798.

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Tong, Jeffrey L., and Andrea J. Gait. "The Upper Lip Bite Test to Predict Difficult Intubation." Anesthesia & Analgesia 106, no. 2 (2008): 668–69. http://dx.doi.org/10.1213/ane.0b013e3181619740.

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Khan, Zahid Hussain. "The Upper Lip Bite Test to Predict Difficult Intubation." Anesthesia & Analgesia 106, no. 2 (2008): 669. http://dx.doi.org/10.1213/ane.0b013e3181619777.

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Lakhe, Gajal, Hari Poudel, and Krishna Murari Adhikari. "Assessment of Airway Parameters for Predicting Difficult Laryngoscopy and Intubation in a Tertiary Center in Western Nepal." Journal of Nepal Health Research Council 17, no. 4 (2020): 516–20. http://dx.doi.org/10.33314/jnhrc.v17i4.2267.

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Background: The screening tests used for pre-operative evaluation of airway to predict difficult laryngoscopy and intubation have variable diagnostic accuracy. The unanticipated poor laryngeal view is gold standard for defining difficult intubation. We aimed to find out the prevalence of difficult laryngoscopy and intubation, which airway parameter better predicts difficult intubation and whether difficult laryngoscopy is associated with difficult intubation or not.Methods: This analytic cross sectional study was conducted in 665 ASA I/II adult patients, aged 18-65, without obvious airway pathology undergoing elective surgery under general anesthesia. The pre-operative screening tests included mouth opening, modified mallampatti, ratio of height to thyromental distance, sternomentaldistance and upper lip bite test. Cormack-Lehane grade III/ IV was defined as difficult laryngoscopy and potentially difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and area under curve at 95% confidence interval was calculated for all five screening tests. Results: The prevalence of difficult laryngoscopy and intubation was 6.6% (44 cases). The upper lip bite test because of its highest specificity, positive predictive value, negative predictive value, accuracy and area under curve (99.7%; 93.9%; 99.7%; 95.2%; 85.1% respectively) with moderate level of sensitivity (70.5%) was better predictor of difficult intubation than other tests. The difficult laryngoscopy was associated with difficult intubation (p=0.00).Conclusions: The prevalence of difficult laryngoscopy and intubation was 6.6%.The upper lip bite test was a better predictor of difficult intubation and there was a significant association of difficult laryngoscopy with difficult intubation.Keywords: Difficult laryngoscopy and intubation; screening tests; upper lip bite test.

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Kolarkar, Priti, Gunjan Badwaik, Ajay Watve, et al. "UPPER LIP BITE TEST : A NOVEL TEST OF PREDICTING DIFFICULTY IN INTUBATION." Journal of Evolution of Medical and Dental Sciences 4, no. 24 (2015): 4149–56. http://dx.doi.org/10.14260/jemds/2015/597.

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Myneni, Neelima, Anthony M. O'Leary, Michael Sandison, and Kevin Roberts. "Evaluation of the upper lip bite test in predicting difficult laryngoscopy." Journal of Clinical Anesthesia 22, no. 3 (2010): 174–78. http://dx.doi.org/10.1016/j.jclinane.2009.06.004.

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Lee, Sang Moo, Doo Sik Kim, Sie Jeong Ryu, Tae Ho Chang, Se Hwan Kim, and Kyung Han Kim. "The Evaluation of Predictability of Difficult Intubation Using Upper Lip Bite Test." Korean Journal of Anesthesiology 49, no. 3 (2005): 287. http://dx.doi.org/10.4097/kjae.2005.49.3.287.

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Asadi Fakhr, Amir, and Masoud Tarbiat. "Comparison Upper Lip Bite Test and Mallampati Test in the Prediction of Difficult Laryngoscopy." Avicenna Journal of Clinical Medicine 26, no. 4 (2020): 241–46. http://dx.doi.org/10.29252/ajcm.26.4.241.

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Chakravarty, Chandrashish, Naveen Yadav, Zulfiqar Ali, and Hemanshu Prabhakar. "Upper lip bite test in a patient with McCune Albright syndrome with acromegaly." Journal of Clinical Neuroscience 17, no. 2 (2010): 258–59. http://dx.doi.org/10.1016/j.jocn.2009.05.021.

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Süer Tümen, Demet, and Orhan Hamamcı. "Comparison of cephalometric changes resulting from different upper incisor intrusion methods." International Dental Research 11, Suppl. 1 (2021): 176–93. http://dx.doi.org/10.5577/intdentres.2021.vol11.suppl1.26.

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Aim: The aim of this study was to provide intrusion of upper incisors with applying Connecticut Intrusion Arch (CIA) and Miniscrew and to evaluate the dental and skeletal cephalometric effects of these intrusion methods on individuals with deep bite caused by supraocclusion of upper incisors. Methodology: The study includes 40 adults, without making sexual distinction, who have at least 4 mm deep bite caused by supraocclusion of upper incisors. Two study groups each consisting 20 individuals formed as CIA and Miniscrew groups. Skeletal, dental, soft tissue measurements were done on lateral cephalograms and apical root resorption measurements were done on standard periapical radiographs that were taken from upper four incisor teeth. Statistically, Paired Student’s t-test was used in intragroup comparements and independent Student’s t-test was used in the investigation of differences between groups. Nevertheless, the concern of variables that seen as risk factors with the amount of resorption was investigated with Pearson correlation analysis.  Results: Successful intrusion of four upper incisor teeth with CIA and Mini screw methods and in-significant difference was determined between two methods. Protrusion of upper and lower incisor teeth decrease in interincisal angle and overbite and increase in overjet was stated by intrusion at both of the methods. The decline of the mesiobuccal cusp of the upper first molar was observed in the CIA method. In soft tissue evaluation, decrease of upper lip length, upper lip thickness and distance of upper and lower lip to the Rickett’s plane was observed. Conclusion: The methods used for intrusion showed to cause similar ratio of root resorption.  How to cite this article: Süer Tümen D, Hamamcı O. Comparison of cephalometric changes resulting from different upper incisor intrusion methods. Int Dent Res 2021;11(Suppl.1):177-94. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.26  Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

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Hemanth, N., T. Rajasekhar, SwamiDevi Prasad Ilapanda, et al. "Comparison of upper-lip bite test with other four predictors for predicting difficulty in intubation." Journal of Clinical and Scientific Research 8, no. 1 (2019): 11. http://dx.doi.org/10.4103/jcsr.jcsr_38_19.

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Vallem, Balasubramanyam, Jamuna Thalisetty, Srikanth Reddy Challapalli, Nicolas Israel, Sowmya Gudise, and Sowjanya Murthigari. "COMPARISON OF UPPER LIP BITE TEST WITH OTHER FOUR PREDICTORS FOR PREDICTING DIFFICULTY IN INTUBATION." Journal of Evolution of Medical and Dental Sciences 4, no. 39 (2015): 6811–17. http://dx.doi.org/10.14260/jemds/2015/988.

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Iqbal, Javaid, Amiya Kumar Barik, Shiv Lal Soni, and Pulkit Bansal. "Challenging airway in a postmandibulectomy patient for carcinoma of the buccal mucosa undergoing laparoscopic cholecystectomy." BMJ Case Reports 15, no. 5 (2022): e248649. http://dx.doi.org/10.1136/bcr-2021-248649.

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Failure to secure the airway after administration of induction agent in a postmandibulectomy patient can lead to life-threatening complications; hence, recognising a difficult airway is of immense importance. Preoperative airway evaluation includes, but is not limited to, inter-incisor gap, modified Mallampati grading, neck movement, neck circumference, thyromental distance, sterno-mental distance, upper lip bite test and dental status. This case signifies the challenge encountered in securing the airway and the importance of thorough preoperative airway evaluation and preparedness before induction of anaesthesia in a postmandibulectomy patient for carcinoma of the buccal mucosa.

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Kala, Gurung Purna, Singh Arun Kumar, Gupta Sandeep, Ali Khawar, and Iqbal Mazar. "Comparison of Upper Lip Bite Test with Modified Mallampati Classification for Prediction of Difficult Endotracheal Intubation." Med Phoenix 4, no. 1 (2019): 21–26. http://dx.doi.org/10.3126/medphoenix.v4i1.25747.

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Sharma, Deepak, Hemanshu Prabhakar, Parmod K. Bithal, et al. "Predicting Difficult Laryngoscopy in Acromegaly: A Comparison of Upper Lip Bite Test With Modified Mallampati Classification." Journal of Neurosurgical Anesthesiology 22, no. 2 (2010): 138–43. http://dx.doi.org/10.1097/ana.0b013e3181ce6a60.

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Date, Aparna, and Alpesh Bhanushali. "Evaluation of upper lip bite test and thyromental height test for prediction of difficult laryngoscopy: A prospective observational study." Airway 4, no. 3 (2021): 185. http://dx.doi.org/10.4103/arwy.arwy_48_21.

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Balakrishnan, Reshma, Philip Mathew, and Saritha Susan Vargese. "Comparison of Modified Mallampati Test and Upper Lip Bite Test in Prediction of Difficult Endotracheal Intubation: A Prospective Study." Indian Journal of Anesthesia and Analgesia 5, no. 8 (2018): 1367–71. http://dx.doi.org/10.21088/ijaa.2349.8471.5818.19.

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Salimi, Alireza, Behrooz Farzanegan, Ali Rastegarpour, and Ali-Asghar Kolahi. "Comparison of the Upper Lip Bite Test with Measurement of Thyromental Distance for Prediction of Difficult Intubations." Acta Anaesthesiologica Taiwanica 46, no. 2 (2008): 61–65. http://dx.doi.org/10.1016/s1875-4597(08)60027-2.

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Karci, A., S. Karagöz, P. Girgin, and D. G. Bozdoǧan. "Comparison of modified Mallampati classification, upper lip bite test and neck circumference in prediction of difficult intubation." European Journal of Anaesthesiology 28 (June 2011): 236. http://dx.doi.org/10.1097/00003643-201106001-00762.

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Stamenkovic, Zorana, Vanja Raickovic, and Vladimir Ristic. "Changes in soft tissue profile using functional appliances in the treatment of skeletal class II malocclusion." Srpski arhiv za celokupno lekarstvo 143, no. 1-2 (2015): 12–15. http://dx.doi.org/10.2298/sarh1502012s.

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Introduction. The effects of orthodontic treatment are considered to be successful if the facial harmony is achieved, while the structures of soft tissue profile are in harmony with skeletal structures of neurocranium and viscerocranium. In patients with skeletal distal bite caused by mandibular retrognathism, facial esthetics is disturbed often, in terms of pronounced convexity of the profile and change in the position and relationship of the lips. Objective. The aim of this study was to determine the extent of soft tissue profile changes in patients with skeletal Class II malocclusion treated with three different orthodontic appliances: Fr?nkel functional regulator type I (FR-I), Balters? Bionator type I and Hotz appliance. Methods. The study included 60 patients diagnosed with skeletal Class II malocclusion caused by mandibular retrognathism, in the period of early mixed dentition. Each subgroup of 20 patients was treated with a variety of orthodontic appliances. On the lateral cephalogram, before and after treatment, the following parameters were analyzed: T angle, H angle, the height of the upper lip, the position of the upper and lower lip in relation to the esthetic line. Within the statistical analysis the mean, maximum, minimum, standard deviation, coefficient of variation, two-factor analysis of variance with repeated measures and the factor analysis of variance were calculated using ANOVA, Bonferroni test and Student?s t-test. Results. A significant decrease of angles T and H was noticed in the application of FR-I, from 21.60? to 17.15?, and from 16.45? to 13.40? (p<0.001). FR-I decreased the height of the upper lip from 26.15 mm to 25.85 mm, while Hotz appliance and Balters? Bionator type I increased the height of the upper lip, thereby deteriorating esthetics of the patient. Conclusion. All used orthodontic appliances lead to changes in soft tissue profile in terms of improving facial esthetics, with the most distinctive changes in the application of Fr?nkel?s functional regulator type I, which is the most successful appliance for achieving the overall facial harmony of the patient.

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Khan, Zahid Hussain, and Shahriar Arbabi. "The Reliability and Validity of the Upper Lip Bite Test Compared with the Mallampati Classification to Predict Difficult Laryngoscopy." Anesthesia & Analgesia 103, no. 2 (2006): 497. http://dx.doi.org/10.1213/01.ane.0000227200.94222.14.

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Richa, Freda, Viviane Chalhoub, Wissam Bou Gebrayel, Christine El-Hage, Patricia El Jamal, and Patricia Yazbeck. "Upper lip bite test versus Modified Mallampati classification in predicting difficult laryngoscopy and/or intubation among morbidly obese patients." Journal of Clinical Anesthesia 63 (August 2020): 109761. http://dx.doi.org/10.1016/j.jclinane.2020.109761.

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L, Shilpa H., V. B. Gowda, and Namratha Ranganath. "Comparison of upper lip bite test with modified Mallampatti classification for predicting difficulty in endotracheal intubation: A prospective study." MedPulse International Journal of Anesthesology 4, no. 3 (2017): 68–71. http://dx.doi.org/10.26611/1015433.

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Journal articles on the topic 'Upper lip bite test (ULBT)'

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