Airway management can be a challenge in a patient with Robin sequence who requires surgery. Mao et al used the findings from craniofacial CT images to identify a patient who may be difficult to intubate. The authors are from Guangzhou Women and Children’s Medical Center in China.

Patient selection: Robin sequence requiring mandibular distraction osteogenesis


Analysis: craniofacial CT


Key measurement: cross-sectional area of the airway at the tip of the epiglottis


If this area is > 36.97 square mm, then difficult intubation is more likely.


If the area is <= 36.97 square mm, then intubation is not difficult.


Performance: The area under the ROC curve was 0.81.


Other findings in the difficult to intubation group:

(1) shorter distance between the root of the tongue and the posterior pharyngeal wall

(2) shallower mandibular angle

(3) smaller cross-sectional area of the tip of the epiglottis

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