The predictors of difficult tracheal intubations in patients undergoing thyroid surgery for euthyroid goitre

Objective: To evaluate the influence of goitre on anatomic features and the correlation of these changes with difficulty in intubation. Methods: A questionnaire was employed to assess 139 patients scheduled for elective surgery of euthyroid goitre to predict the potential of difficult intubation. These measurements were later correlated with the patients who eventually had difficult intubations. Neck circumference, mouth width, lip test, sternomental distance, thymomental distance, Mallampati score and laryngeal palpation were evaluated. Results: All predictors were found to be significant as single predictors but on logistic regression analysis it was found that the circumference of the neck alone, was the independent predictor for difficult intubation. Conclusion: Neck thickness in patients with goitre is a significant predictor of difficult intubation and should be used in preoperative assessment to anticipate difficult intubations.