Samra S K, Schork M A, Guinto F C
Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor 48109-0048, USA.
J Clin Anesth. 1995 Aug;7(5):373-9. doi: 10.1016/0952-8180(95)00067-r.
To study whether a detailed radiographic examination of neck and upper airway can help identify normal looking patients in whom endotracheal intubation may be difficult; determine whether such parameters as identified by magnetic resonance imaging (MRI) can also be identified in a soft tissue radiograph; and to study the correlation between oropharyngeal appearance, based on Mallampati's classification, and laryngoscopic findings in a large number of patients requiring endotracheal intubation.
Prospective.
University medical center.
20 adult patients in whom an unanticipated difficult endotracheal intubation was encountered, and a control group of 20 patients in whom endotracheal intubation was easily accomplished.
Difficult-to-intubate patients were identified according to prospectively established criteria. Control subjects, in whom the trachea was easily intubated, were matched for age, gender, height, weight, and oropharyngeal appearance.
In all 40 study patients, a soft tissue radiograph and an MRI scan of the neck were obtained. We measured 21 parameters from both radiographic studies. There were no significant differences between the two groups in 20 of 21 measured parameters on MRI scans and soft tissue radiographs. Only one measurement--the distance between the uppermost visible part of the airway and the posterior pharyngeal wall (measured from MRI scans only)--between the two groups achieved statistical significance. The values recorded from MRI and soft tissue radiographs were not significantly different. Airway grading system first suggested by Mallampati had a fair correlation with laryngoscopy findings associated with a difficult endotracheal intubation.
No significant difference between the two groups could be identified on soft tissue radiography or MRI scans.
研究颈部和上气道的详细影像学检查是否有助于识别看似正常但可能存在气管插管困难的患者；确定磁共振成像（MRI）所识别的参数是否也能在软组织X线片中被识别；研究基于Mallampati分类的口咽外观与大量需要气管插管患者的喉镜检查结果之间的相关性。
前瞻性研究。
大学医学中心。
20例遇到意外困难气管插管的成年患者，以及20例气管插管顺利完成的对照组患者。
根据预先确定的标准识别插管困难的患者。气管插管顺利的对照受试者在年龄、性别、身高、体重和口咽外观方面进行匹配。
对所有40例研究患者进行了颈部软组织X线片和MRI扫描检查。我们从两项影像学研究中测量了21个参数。在MRI扫描和软组织X线片的21个测量参数中，两组之间有20个参数无显著差异。两组之间只有一项测量结果具有统计学意义，即气道最上部可见部分与咽后壁之间的距离（仅从MRI扫描测量）。MRI和软组织X线片记录的值无显著差异。Mallampati首次提出的气道分级系统与气管插管困难相关的喉镜检查结果有一定相关性。
在软组织X线摄影或MRI扫描中，两组之间未发现显著差异。
