Comparison of the Acromio Axillosuprasternal Notch Index with Ratio of Height to Thyromental Distance and Mallampati Classification for the Anticipation of Difficult Intubation in Apparently Normal Patients
Year: 2025
Type: article
Study design: Observational Study
Abstract: Airway management is crucial in anaesthesia, with difficult intubation posing risks. The Acromio Axillo acromio-axillo-suprasternal notch Index (AASI) has shown promise in predicting difficult airways. This study compares AASI with height to thyromental distance ratio and Mallampati classification in anticipating difficult intubation. A prospective observational study at Saveetha Medical College & Hospital assessed 60 patients from September 2023 to August 2023. Inclusion criteria were ages 18-60 and consent for elective surgery under general anesthesia. Exclusions included distorted head and neck anatomy, mouth opening < 3 cm, obesity, sleep apnea, pregnancy, or refusal. Measurements utilized a Thyromental scale. Participants (n=60) had a mean age of 35.021 years, with 45% males and 55% females. The mean BMI was 31.182. Most were ASA class 2 (66.6%) and MMP grade 2 (46.6%). AASI >0.5 was seen in 76.6% of participants. CL Grade distribution showed 33.3% in Grade 1 and 73.3% in Grades 1 and 2 combined. AASI emerged as a superior predictor for Difficult Visualization of the Larynx (DVL), surpassing MMP and TMD. Its heightened sensitivity makes it an effective screening tool, complementing existing methods. Further studies are needed to validate these findings and assess AASI's applicability across diverse patient populations. Integrating AASI into routine clinical practice may enhance patient outcomes by enabling proactive airway management strategies in high-risk individuals.
Authors: Nagapriya Nagendran, Sathyapriya Sathiyamoorthy, Lakshmi R, Maghimaa, M, Hemapriya Namassivayam, Bharath S
Institution: Saveetha University
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4408918512