Mao et al reported a clinical prediction rule for identifying a child with Robin sequence who will be difficult to intubate. The rule is based on measurements taken with craniofacial CT. The authors are from Guangzhou Women and Children's Medical Center in China.

Patient selection: Robin sequence, apparently a neonate


Exam: craniofacial CT


Outcome: need for mandibular distraction osteogenesis


The key finding was the cross-sectional area of the upper airway at the epiglottis tip. If the area is >= 36.97 square mm is associated with difficult intubation.


This finding was 100% sensitive and 63% specific for difficult intubation.


Other findings associated with difficult intubation (using designations from  Table 1):

(1) shorter distance between the root of the tongue and posterior pharyngeal wall (D6, <= 2 mm)

(2) shallower mandibular angle bilaterally (A5, < 131 degrees)

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