Predicton of Difcult Intubaton with the Modifed Mallampat and Upper Lip Bite Test: A Cross-Sectonal Analysis Muhammad Tayyeb 1 , Shah Faisal 2 , Abdullah 3* , Muhammad Ajmal 1,4 , Naqash Ahmad 1 , Muhammad Arsalan 1 , Ayesha Jehad 5 , Bashir ul Haq 1 , Said Khitab Shah 1 and Muhammad Qasim Jan 6 1 Department of Anaesthesia, Khyber Medical University, Peshawar, KPK, Pakistan 2 Department of Biotechnology, Bacha Khan University, Charsadda, KPK, Pakistan 3 Department of Microbiology, Abdul Wali Khan University, Mardan, KPK, Pakistan 4 Department of Anaesthesia, Hayatabad Medical Complex Peshawar, KPK, Pakistan 5 College of Medical Technology, Medical Teaching Insttutons Bacha Khan Medical College Mardan, Pakistan 6 Department of Anaesthesia Qazi Hussain Ahmad Medical Complex, Pakistan * Corresponding author: Abdullah, Department of Microbiology, Abdul Wali Khan University, Mardan, KPK, Pakistan, E-mail: abdul. 9353chd@gmail.com Received date: May 23, 2020; Accepted date: May 27, 2020; Published date: June 5, 2020 Citaton: Tayyeb M, Faisal S, Abdullah, Ajmal M, Ahmad N, Arsalan M, et al. (2020) Predicton of Difcult Intubaton with the Modifed Mallampat and Upper Lip Bite Test: A Cross-Sectonal Analysis. J Biomed Sci Vol.9 No.2:5. Abstract Difcult intubaton is a term used when inserton of the endotracheal tube with conventonal laryngoscopy technique requires more than 10 minutes or greater than three atempts. This study sought to determine the predictve value of two commonly used tests; Mallampat test vs. Upper Lip Bite Test (ULBT). A cross-sectonal study conducted on 196 patents aged 18-60 years in lady reading hospital Peshawar presented for electve surgeries planned for general anaesthesia and requiring endotracheal intubaton were included during March 2018 to May 2018. Both tests (Mallampat and Upper lip bite test) were performed on each sample. In the total 196 partcipant 180 (91.8%) were found easy cases and 16 (8.2%) were difcult cases. Out of 16 (8.2%) difcult cases 5 (31.3%) difcult cases were underclass III Upper Lip Bite Test (ULBT) which are true positve. From Modifed Mallampat Test 8 (50%) were atributed to MMT class III which is 21.1% of total class III and 3 cases (18.8% of total difcult cases) with MMT class IV which is 75% of MMT class IV are both true positve. During anaesthesia and intubaton, most common cause of death and brain damage is encounter because of difcult intubaton. In this study, we have performed two tests i.e. ULBT and MMT on total of 196 patents, out of which 16 (8.2%) were found difcult intubaton which is in the range (0.5- 17.5%) menton in the previous studies. The study has shown most of the difcult were predicted incorrectly. Most cases resulted in difcult intubaton, which were predicted easily by two tests (Criteria set by Hoda et al.), so to only rely on ULBT and MMT for predictve measure is not standard. Keywords: Modifed mallampat test; Upper lip bite test; Difcult intubaton; Anaesthesia; Laryngoscopy; Predictve Introducton The meaning of difcult intubaton is ‘the need of more atempts for intubaton or taking more than 10 minutes during laryngoscopy or use of special equipment (instrument) for intubaton or not viewed on laryngoscopy using Cormack- lehane classifcaton ’ The presence of only one will consider difcult intubaton [1,2]. As reported the incidence of difcult endotracheal intubaton is between 1.3% and 13% in patents undergoing general anaesthesia. Incidence of failed intubaton varies from 0.05% to 0.35% whereas 0.01%-0.02% is incidence of inability to intubate and ventlate [1,3]. The most serious complicaton recorded by anaesthetst is a difcult airway (In which anaesthetst cannot deliver oxygen to the lungs). Around half of the cases are not recorded and are not predicted [4]. Many causes of difcult intubaton, the important iatrogenic cause is an unexperienced and unprepared anaesthetst. Other cause due to anaesthetst includes inadequate preoperatve assessment, equipment preparaton, inexperienced and poor technique whereas equipment related causes is a malfuncton of equipment and unavailability of proper equipment. Causes other than aesthetc and equipment are patent causes that may be acquired (reduced neck or jaw movement, Tumour, nerve palsy) or congenital (Down syndrome, Marfan syndrome, Treacher Collins syndrome) [5,6]. Difcult intubaton leads to iMedPub Journals www.imedpub.com DOI: 10.36648/2254-609X.9.2.5 Journal of Biomedical Sciences ISSN 2254-609X Vol.9 No.2:5 2020 © Copyright iMedPub | This article is available from: https://www.jbiomeds.com/ 1 Abbreviation: MMT: Modified Mallampati Test; ULBT: Up- per Lip Bite Test Research Article test