What question did this study set out to answer?

This study aims to identify factors that predict successful first-pass video-laryngoscope-guided nasal intubation in patients with oral cavity tumors and limited mouth opening.

February 26, 2026Airway0 citationsOpen Access

View Full Paper

A Prospective Observational Study to Identify the Predictors of First Pass Success with Video-Laryngoscope-Guided Nasal Intubation in Patients with Restricted Mouth Opening in Oral Cavity Tumours

ARAishwarya RamkrishnanCancer Institute (WIA)PSP R Pravin SankarCancer Institute (WIA)

Key Points

This study aims to identify factors that predict successful first-pass video-laryngoscope-guided nasal intubation in patients with oral cavity tumors and limited mouth opening.
Conducted a single-centre prospective observational study
Measured airway parameters using ultrasound and conventional methods
Intubated patients using the C-MAC D-Blade video-laryngoscope
Defined successful intubation as first-attempt in under 60 seconds without adverse events
Successful first-pass intubation rate was 12.79%
17.2% of intubations required more than one attempt due to difficult laryngoscopy
Mean interincisor distance for successful intubation was 2.97 ± 0.61 cm
HMDR and ICD were identified as reliable predictors of intubation difficulty

Abstract

Abstract Background and Aim: Video-laryngoscopes are commonly used for intubation in patients with restricted mouth openings. However, the predictors of difficult video-laryngoscope-guided intubation have not been clearly defined in the literature. The primary objective of this study was to identify the parameters that predict first-pass success with video-laryngoscope-guided nasal intubation in patients with oral cavity tumours and restricted mouth openings. The secondary objective was to determine the minimum mouth opening above which successful first-attempt intubation with a video-laryngoscope was achieved in this population. Methodology: After Institutional Review Board approval, a single-centre prospective observational study on 30 oral cavity tumour patients with mouth openings <5 cm was conducted. Both conventional and ultrasound-guided airway parameters – intercondylar distance (ICD), tongue thickness, skin to hyoid distance (DSH), skin to epiglottis distance (DSE) and hyomental distance ratio (HMDR) – were measured after screening. Patients were intubated with C-MAC D-Blade video-laryngoscopy. Successful safe video-laryngoscopy intubation is defined as first-attempt intubation, intubation time <60 s, without using any adjuncts and no adverse events. Results: The incidence of safe single-pass intubation was 12.79%, and the incidence of difficult laryngoscopy requiring more than 1 attempt was 17.2%. The mean interincisor distance, which was intubated within 60 s, was 2.97 ± 0.61 cm. Amongst the ultrasound parameters, HMDR was significantly different ( P = 0.05) in two groups requiring more than one attempt at intubation. ICD has a positive correlation with interincisor distance (IID). Conclusion: In patients with oral cavity tumours, restricted mouth opening, HMDR and ICD are the reliable predictors of difficult intubation with a video-laryngoscope. IID of 2.97 ± 0.61 cm was safely intubated within 60 s.

KI fragen

Bookmark

View Full Paper

Cite This Study

Ramkrishnan et al. (Thu,) studied this question.

synapsesocial.com/papers/699fe3af95ddcd3a253e7b0c https://doi.org/https://doi.org/10.4103/arwy.arwy_26_25

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

KI fragen

Bookmark

View Full Paper