TY - CHAP M1 - Book, Section TI - Chapter 10. Evaluation of the Patient with a Difficult Airway A1 - Phero, James C. A1 - Patil, Yash J. A1 - Hurford, William E. A2 - Longnecker, David E. A2 - Brown, David L. A2 - Newman, Mark F. A2 - Zapol, Warren M. PY - 2012 T2 - Anesthesiology, 2e AB - A patient with a history of difficult intubation should be treated as having a difficult airway, even though physical appearance and physical examination may be unremarkable.A patient with anatomic variations indicative of possible difficult intubation should receive a careful history and physical examination to define the extent of the potential airway problem.Possible or potentially difficult intubation may be predicted by the Mallampati test, evidence of receding mandible, limited mouth opening as a result of tissue or temporomandibular joint (TMJ) restriction, enlarged teeth, high arched palate, narrow small mouth, or restricted cervical spine movement.All current tests to predict difficulty with airway management are associated with a high incidence of false-positive and false-negative results and have low predictive value. To minimize airway-related complications, it is optimal to accept a high incidence of false-positive predictions by the various tests and treat any patient identified as having a possible difficult intubation accordingly.Unexpected failed ventilation and intubation may result from oropharyngeal, laryngeal, or tracheal pathology that may not be identified by external examination.In pediatrics, infection-related airway compromise and congenital airway malformations are the major airway management problems.In adults, stridor at rest indicates a serious degree of obstruction with a cross-sectional opening less than 4 mm.Upper airway endoscopy with a standard or videolaryngoscope and/or fiberoptic bronchoscope is useful in defining anatomic challenges in patients with upper airway pathology before induction of general anesthesia. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/29 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=56622740 ER -