The Assessment of Risk Factors for Difficult Intubation in Thyroid Patients

World J Surg. 2018 Jun;42(6):1748-1753. doi: 10.1007/s00268-017-4391-y.

Abstract

Objectives: We aimed to assess possible risk factors related to difficult intubation in patients undergoing thyroid surgery.

Methods: We prospectively collected data of 200 patients scheduled for thyroid surgery. Clinical risk factors were defined as: Mallampati score, interincisor gap, thyromental distance, sternomental distance, range of neck motion, body mass index, neck circumference, goiter, the presence of radiological findings suggesting compression and thyroid weight. All evaluations were performed with Macintosh assessed for Cormack and Lehane (CL) classification and modified intubation difficulty scale (MIDS).

Results: It was observed that the proportion of patients with a thyroid weight ≥40 g, goiter, a Macintosh CL score = 3-4 and the mean neck circumference were significantly higher in the group with a MIDS score >5 (p = 0.018, p = 0.011, p < 0.001, respectively).

Conclusion: The presence of a palpable goiter, thyroid weight ≥40 g and thyromental distance <6.5 cm were risk factors associated with difficult intubation in the multivariate regression model.

MeSH terms

  • Adult
  • Aged
  • Female
  • Goiter / surgery*
  • Humans
  • Intubation, Intratracheal / methods*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Thyroid Gland / surgery*