The airway exam is an important part of the pre-operative exam as it allows for appropriate planning and acquisition of necessary resources for airway management. There are several components of the airway exam as below. The combined evaluation of Mallampati, thyromental distance (TMD), upper lip bite test (ULBT), and C-spine mobility improves accuracy of prediction as compared to using any measure alone.
- Mallampati score/mouth opening
- Cervical spine mobility
- Very common
- Increased likelihood of more difficult intubation when present in conjunction with other risk factors (Mallampati 3-4, TM distance <6cm)
- Temporomandibular joint mobility
- Upper lip bite test (ULBT) can help to evaluate
- Class 1: lower incisors can bite upper lip above vermilion line
- Class 2: lower incisors can bite upper lip below vermilion line
- Class 3: lower incisors cannot bite upper lip
- Thyromental distance (TMD)
- <5-6cm is short TMD
- Consider smaller blades (Mac 2) to decrease attempts
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