Prediction of difficult airway by comparision of Mallampatti test with acromioaxillarysuprasternal notch index(AASI)

Mintaininga patent airway following the induction of general anesthesia is undeniably themost imperative concern for an anesthesiologist. The incidence of difficultlaryngoscopy or tracheal intubation was reported to be in the range of0.1to20.2%. Unanticipated difficult intubation can lead to difficult or lack ofventilation in anesthetized patients and can cause morbidity or mortality. Predictionof difficult intubation in preoperative evaluation includes test based on anatomicallandmarks such as modified Mallampati test (MMP), interincisive distance,thyromental distance (TMD), sternomental distance, upper lip bite test, andhyomental distance. All tests nave different sensitivities and specificities. Experiencedanesthesiologist had observed difficult visualization of larynx (DVL) inindividuals whose neck was situated deep in the chest (i.e. with a slopingclavicle). Test based on the surface anatomy of the upper chest - measuringacromioaxillary distance above the line drawn from supra-sternal notch might beused as an indicator to predict difficult airway. This,study is designed to compare simple, cost effective acromioaxillosuprasternalnotch index (a new test) with modified mallampati test in predicting difficultvisualization of larynx