Mandibular Condylarmobility Sonography Measurements To Predict Difficult Airway

Objective: Mandibular condylar mobility,as measured by sonography,is a new reliable method for temporomandibular joint(TMJ)mobility assessments.However,compared with other related assessment methods,it is still uncertain whether limited mandibular condylar mobility sonography measurements can predict difficult airway,especially difficult laryngoscopy.This study was to observe its capacity for predicting difficult laryngoscopy.Methods: Adult Patients who were administered tracheal intubations for elective surgery under general anesthesia were enrolled in the study excluding the patient with maxillofacial trauma,anodontia,and uncooperative behaviour.Mandibular condylar mobility was assessed by sonography through condylar translation measurements.Other variables that correlated with temporomandibular joint mobility,such as inter-incisor distance,mandibular protrusion distance,upper lip bite test were also evaluated before anesthesia.After inductionofgeneralanesthesia,the Cormack-Lehane level of every patient was recorded.Results: A total of 536 patients were prospectively included,and difficult laryngoscopy were reported in 47 patients.The condylar translation prediction criteria for difficult laryngoscopy was ?10mm.Among observed predictors,the condylar translation owned the highest correlation(r =-0.467,P < 0.001)and the highest area under the receiver operating characteristic curve(0.958)with difficult laryngoscopy.The condylar translation?10mm had the highest Kappa value(Kappa = 0.687,95% CI: 0.586 to 0.788)with difficult laryngoscopy.limited condylar translation had highest predictive values in odds ratios(122,95% CI: 47 to 313),sensitivity(0.872,95% CI: 0.743 to 0.952),specificity(0.947,95% CI: 0.923 to 0.965),and positive predictive value(0.612,95% CI: 0.484 to 0.725),negativepredictive value(0.987,95% CI :0.972 to 0.995)?Conclusion: Among temporomandibular joint mobility assessments,mandibular condylar mobility,as assessed by sonography,was highly correlated with difficult laryngoscopy,and owned higher predictive property.