THE UPPER LIP BITE TEST
PREDICTION OF DIFFICULT ENDOTRACHEAL INTUBATION
DOI:
https://doi.org/10.29309/TPMJ/2005.12.04.5097Keywords:
Upper lip bite test, Endotracheal intubation, Difficult intubation, Mallampati classification, Thyromental distance, Mouth openingAbstract
Objective: We conducted a prospective, double-blind study to
determine whether a difficult endotracheal intubation could be predicted preoperatively by a simple new technique, the
upper lip bite test and compared it with three other tests used for prediction of difficult intubation: Modified Mallampati
criteria (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 lip
bite test (ULBT), class I: lower incisors can bite the upper lip above the vermilion line; class II: lower incisors can bite
the upper lip below the vermilion line; class III: lower incisors cannot bite the upper lip; (2) Oropharyngeal class
according to the MMC. (3) The distance between the chin and thyroid cartilage (thyromental distance). (4) Extend of
maximum mouth opening test. Results: ULBT had significantly higher accuracy (96%) and specificity (98.3%) and the
lowest rate of false positive (p< 0.001). The most sensitive test was the TM test (42%). Conclusion: We concluded
that comparison of the three tests, UPBT has sufficient value in predicting difficult intubation in adults
