Airway Assessment: A Critical Appraisal

The ability to predict the difficult airway to preempt difficult intubation would decrease the most common damages seen in the administration of anaesthesia. Many tests have been put forth over the years, some necessitating detailed quantitative measurements like the sternomental distance, thyromental distance and inter-incisor gap but others like the upper lip bite test is of a qualitative nature which makes it easier to use and is more precise. The setback in most tests has been their sensitivity, specificity, positive and negative predictive value to allow accurate prediction of the possibility of difficult intubation. Combination of the tests has not improved the various attributes to improve accuracy. The most important impediment to the continued search of a comprehensive test is the low occurrence of the difficult airway. There may be a combination of complex factors interacting in an incomprehensible manner to make the process of intubation difficult.