Comparison of Difficult Airway with Dental Malocclusions during Laryngoscopy with Video Laryngoscopy in Patients Undergoing Elective Surgery

Abstract

Background: Managing difficult airways in surgical patients remains a significant challenge for primary care physicians and anesthesiologists, often leading to high-stress situations. Dental malocclusion is a critical factor that can complicate airway management during laryngoscopy. To investigate the relationship between dental malocclusion classes and difficult airway indicators, such as video laryngoscopy grade and Malampathi criteria, in patients undergoing elective surgery. Materials and Methods: This descriptive-analytical study randomly sampled patients scheduled for elective surgery at Shahid Mohammadi Hospital in 2022. Data were collected using a checklist that included variables such as age, sex, height, weight, dental malocclusion class, Malampathi scale, and video laryngoscopy grade. The Chi-square test and multiple logistic regression were applied to compare proportions between groups. A p-value of <0.05 was considered statistically significant. Results: The study found no significant relationship between dental malocclusion class and height, weight, or age. However, the prevalence of malocclusion across all three classes was higher in male patients. A significant association was observed between dental malocclusion class and both Malampathi criteria and video laryngoscopy grade (P<0.005). Specifically, as the malocclusion class increased, both the laryngoscopy grade and Malampathi grade also increased. Conclusion: This study highlights a significant relationship between dental malocclusion class and difficult airway indicators, such as video laryngoscopy grade and Malampathi criteria. Higher grades of laryngoscopy grade and Malampathi criteria were associated with Class 2 and Class 3 dental malocclusions. These findings underscore the importance of dental occlusion assessment in predicting and managing difficult airways in surgical patients.