Examination of Submental Space as an Alternative Method of Airway Assessment (Submental Sign)

• Main Author: Javid Mihan J
• Format: Article
• Language: English
• Published: BMC 2011-06-01
• Series: BMC Research Notes
• Online Access: http://www.biomedcentral.com/1756-0500/4/221

<p>Abstract</p> <p>Background</p> <p>Difficult airway especially failed intubation has been associated with a high incidence of mortality and morbidity. Most of mortalities occur when an anaesthesiologist encounters an unanticipated difficult airway.</p> <p>Findings</p> <p>In 1999, a 23 yr. old, 65 kg weight and 170 cm height female patient had been scheduled for arthroscopy. Despite totally normal airway assessment (thyromental distance, mouth opening, jaw and neck movement ...) I was astonished by encountering a grade IV Cormack - Lehane laryngoscopic view. Tracheal intubation was impossible and ventilation was very difficult.</p> <p>On attempt to attain a better laryngoscopic view, while manipulating submandibular region I encountered a bulky noncompliant submental space (Submental Sign). This event made me more alert regarding this finding. Thereafter I noted for this sign throughout the past years and I found it very helpful.</p> <p>These findings encouraged me to write this report, and suggest a routine examination of submental space in order to keep the safety of the patient at the heart of the care we provide.</p> <p>Conclusion</p> <p>Evaluation of the submental space is suggested as an alternative predictor of difficult airway and routine examination of the submental space is of value in airway assessment.</p>