Anatomical and Ultrasonographic Analyses of the Levator Labii Superioris Alaeque Nasi Muscle at the Level of the Nasal Ala / Análisis Anatómico y Ecográfico del Músculo Elevador Nasolabial a Nivel del Ala Nasal

SUMMARY: We aimed to determine the width of the levator labii superioris alaeque nasi muscle (LLSAN) at the level of the nasal ala through cadaveric dissections and ultrasonography (US), to provide essential anatomical information for use during both invasive and noninvasive procedures in the nasal ala region. The LLSAN was investigated in the 40 hemifaces of 20 Korean cadavers, comprising 10 males and 10 females with a mean age of 73.6 years. The LLSAN width of the 40 specimens at the level of the midpoint of the nasal ala was 5.02±2.35 mm (mean±standard deviation), and ranged from 1.45 mm to 10.11 mm. The LLSAN widths were 5.96±2.36 mm and 3.93±1.89 mm in males and females, respectively, with ranges of 2.40-10.11 mm and 1.45-6.96 mm, respectively. The LLSAN widths on the left and right sides were 4.77±2.72 mm and 5.26±1.99 mm, respectively. The proportions of the LLSAN fibers inserting into the nasal ala and upper lip were similar in 13 specimens (32.5 %), while more fibers inserted into the nasal ala in 11 specimens (27.5 %) and more fibers inserted fibers of the LLSAN into the upper lip in 16 specimens (40 %). When clinicians need to target or avoid the LLSAN, the present width and range data can be helpful for ensuring the efficacy and safely of both invasive and noninvasive procedures. In addition, the possibility of asymmetry in the width of the LLSAN in the nasal ala region should be confirmed by US before performing such procedures.

Nuestro objetivo fue determinar el ancho del músculo elevador nasolabial (MENL) a nivel del ala nasal mediante disecciones cadavéricas y ecografía, para proporcionar información anatómica esencial, para su uso durante procedimientos invasivos y no invasivos, en la región del ala nasal. El MENL se estudió en 40 hemicaras de 20 cadáveres coreanos (10 hombres y 10 mujeres) con una edad media de 73,6 años. El ancho de MENL de las 40 muestras a nivel del punto medio del ala nasal fue de 5,02 ± 2,35 mm (media ± desviación estándar) y osciló entre 1,45 mm y 10,11 mm. Los anchos de MENL fueron 5,96 ± 2,36 mm y 3,93 ± 1,89 mm en hombres y mujeres, respectivamente, con rangos de 2,40 a 10,11 mm y 1,45 a 6,96 mm, respec- tivamente. Los anchos de MENL en los lados izquierdo y derecho fueron 4,77 ± 2,72 mm y 5,26 ± 1,99 mm, respectivamente. Las proporciones de fibras de MENL que se insertaban en el ala nasal y en el labio superior fueron similares en 13 muestras (32,5 %), mientras que se insertaron más fibras en el ala nasal en 11 muestras (27,5 %) y además, se insertaron fibras de MENL en el labio superior en 16 ejemplares (40 %). Cuando los médicos necesitan apuntar o evitar el MENL, los datos actuales de ancho y rango pueden ser útiles para garantizar la eficacia y seguridad de los procedimientos, tanto invasivos como no invasivos. Además, la ecografía puede ser utilizada para confirmar una posible asimetría en el ancho del MENL en la región del ala nasal antes de realizar los procedimientos.

3D finite element analysis of the influence of upper lip pressure on the maxilla for patients with unilateral alveolar cleft / 口腔疾病防治

Objective @#To investigate the biomechanical effects of upper lip pressure on the maxilla in patients with a unilateral alveolar cleft and provide evidence for clinical diagnosis and treatment. @*Methods @#A 3D finite element maxillary model was generated based on cone beam CT (CBCT) data from an 11-year-old female patient with a unilateral alveolar cleft. Two different kinds of upper lip pressure, postsurgery pressure and normal pressure, were applied to the model. The displacement and stress of each reference node were compared and analyzed. @*Results @# By loading upper lip pressure, the maxillary alveolar crest rotated toward the defect and was displaced downward and backward. The displacement of the noncleft side was greater than that of the cleft side and it decreased gradually from the anterior to the posterior. The stress was concentrated on the anterior portion of the alveolar crest. The stress on the noncleft side was greater than that on the cleft side and it decreased gradually from the anterior to the posterior. The maximum stress was concentrated on the palate around the defect. The displacement and stress in the postsurgery group were greater than those of the normal group (P<0.05). @*Conclusion @#By loading upper lip pressure, the maxilla demonstrated asymmetry three-dimensionally. The adverse effects on the maxilla could be mitigated by reducing the upper lip pressure.

Effect of modified upper lip lifting by retaining nasal columellar base incision / 中华医学美学美容杂志

Objective:To investigate the effectiveness of a modified upper lip lifting technique with retaining the nasal columellar base incision.Methods:From Jun. 2019 to Jun. 2020, 24 cosmetic patients (aged from 18 to 36 years, with mean 26.5 years) underwent upper lip lifting with skin flap resection of bilateral upper lip flaps and retained the nasal columellar base in Chengdu High-Tech Zone Xinyuerong Medical Aesthetic Clinic. These factors were analyzed, including postoperative complications, improvement of nasolabial angle, effectiveness of upper lip lifting and overall satisfaction.Results:In the 24 patients, 2 patients had numbness in the upper lip after surgery, and returned to normal after 4 months. The concealed scar was effective to improve the linear scar and scar contracture of traditional upper lip lifting. All patients were followed up for 3 months to 1 year. The satisfactory lifting effectiveness was obtained in 24 cases. As for overall satisfaction, 22 cases were very satisfied (91.7%) and 2 cases were satisfied (8.3%).Conclusions:This upper lip lifting surgical procedure of upper lip flaps with retaining the nasal columellar base incision has changed the traditional method to avoid the upper lip horizontal line scar, nasolabial angle contracture, while ensuring the columellar base blood supply is not damaged, with minimized and concealed scar. This surgical procedure is a safe and effective method and worth clinical application.

Evaluation of difficult airway in paediatric population ranging from 5-12 years age group

Background: The aim of this study is to predict difficult airway on the basis of various airway assessment parameter in the paediatric population between 5-12 years age group. To assess the value of modified Mallampati test (MMT), upper-lip-bite test (ULBT), thyromental distance (TMD), ratio of height to thyromental distance (RHTMD) from which Cormack Lehane grade was derived to predict difficult airway i.e. difficult intubation in paediatric patients ranging from 5-12 years age. Material and Methods: 100 ASA grade I & II paediatric patients of either sex between the age group of 5-12 years posted for elective surgery under general anaesthesia requiring endotracheal intubation were included in the study. Modified Mallampati test, upper lip bite test, thyromental distance and ratio of height to thyromental distance of the patients were measured and recorded. All the distances were measured with the help of a flexible measuring tape so as to measure the distances accurately. Results: Modified Mallampati test has the highest sensitivity (75%) and specificity (92.05%) among all the other screening tests. It also has high positive predictive value (56.25%), negative predictive value (96.43%) and diagnostic accuracy (90%). Upper Lip Bite test has high specificity (79.55%) and negative predictive value (93.33%) with high diagnostic accuracy (77%). It has a sensitivity of 58.33% which is similar to the sensitivity of thyromental distance and ratio of height to thyromental distance. Thyromental distance has high specificity (65.90%) with high negative predictive value (92.06%). Conclusion: Modified Mallampati test is a useful bedside screening test for predicting difficult intubation in patients between 5-12 years age group. The Upper Lip bite test and thyromental distance has high specificity with high negative predictive value and diagnostic accuracy. The ratio of height to thyromental distance is least useful predictor of airway assessment.

Comparison Of Upper Lip Bite Test And Modified Mallampati Classification In Predicting Difficult Intubation

Introduction : Airway management is of prime importance to the Anaesthesiologist for securing the airway, tracheal intubation using direct laryngoscopy remains the method of choice in many cases. Difficult laryngoscopic endotracheal intubation still remains an important concern of anaesthesiologists. The incidence of difficult endotracheal intubation were reported to be between 1.5% to 13% among patients undergoing surgery. The present study was conducted with the primary aim to evaluate sensitivity, specificity, accuracy, negative predictive value and positive predictive value of Upper Lip Bite Test and Modified Mallampati Classification to predict difficult intubation in patients undergoing any elective surgery under general anesthesia. Material & Methods : A single-blind, Prospective Observational (Analytical) study was conducted in Krishna Institute of Medical Sciences, Hospital and Research Centre, Karad, Maharashtra after the approval from the institutional ethical committee. Asample size of 181 patients of both gender, between 20 and 50 years of age, belonging to ASAphysical Status I-II scheduled to undergo elective surgery under general anaesthesia with endotracheal intubation were evaluated for both test before surgery after fulfilling the inclusion criteria. A senior Anaesthesiologists having minimum five years of experience in clinical anaesthesia who unaware of preoperative airway assessment, performed laryngoscopy and grading as per Cormack and Lehane's classification. Senstivity, specificity,accuracy, positive and negative predictive values of Upper lip bite test and Modified Mallampati Classification were calculated. Results:We compared various accuracy parameters of both the methods (MMTand ULBT), we observed that MMT(88.23% Vs. 76.47%) has got higher sensitivity, higher specificity of (89.02% Vs. 87.19%), higher positive predictive value (45.45% Vs. 38.23%) and higher negative predictive value (98.64% Vs. 97.27%) as compared to ULBT. Conclusion : In comparison with ULBT, MMT has got better predictive ability for difficult endotracheal intubation. MMT and ULBT appear to be better predictors for easy intubations rather than difficult intubations (high negative predictive value). Combination of MMT and ULBT has got better diagnostic accuracy as compared to MMTor ULBTalone.

Glomus tumor of the oral cavity: report of a rare case and literature review

Abstract Glomus tumor is a benign neoplasm composed of a perivascular proliferation of glomic cells that resembles the normal glomus body. Usually, it appears as a solitary, symptomatic small blue-red nodule, located in the deep dermis or subcutis of upper or lower extremities of young to middle-aged adults. Cases affecting the oral cavity are very rare, with only 23 well-documented cases reported in the English-language literature. Herein, we present a rare case of glomus tumor of the upper lip, and review the literature of cases involving the mouth.

Resumo Tumor glômico é uma neoplasia benigna composta de uma proliferação perivascular de células glômicas que lembram o corpo glômico normal. Usualmente, ele se apresenta como um nódulo pequeno, solitário, sintomático e azul-avermelhado, localizado na derme profunda ou subcutânea de extremidades superiores ou inferiores de adultos jovens e de meia-idade. Casos afetando a cavidade oral são muito raros, com apenas 23 casos bem documentados relatados na literatura de língua Inglesa. A seguir, nós apresentamos um caso raro de tumor glômico do lábio superior, e revisão da literatura dos casos envolvendo a boca.

V-Y advanced flap with facial artery perforator for repairing the upper lip defect / 中华整形外科杂志

Objective@#To evaluate the feasibility and clinical effect of V-Y advanced flap with facial artery perforator for repairing the upper lip defect.@*Methods@#Between January 2014 and March 2017, 29 cases with the upper lip tumor or additional scar resulted from trauma. The lesions size ranged from 0.8 cm×2.0 cm-1.9 cm×3.0 cm in diameter. V-Y advanced flap with facial artery perforator was designed according to the size, shape and the location of the wound, and the donor site was closed directly.@*Results@#All the 29 flaps survived completely, including four cases appeared vein congestion at the distal region of the flap, and recovered after active conservative treatment. All the patients were followed up for 3 to 15 months (on average 8 months), with no tumor recurrence, inconspicuous scar. All the patients were satisfied with their function and appearance.@*Conclusions@#V-Y advanced flap with facial artery perforator, which could achieve good cosmetic and functional effect, with little influence to the donor site, is an optimal choice to reconstruct the defect of the upper lip.

Propeller facial artery perforator flap for repairing defect after resection of skin malignant tumor at upper lip / 中国修复重建外科杂志

Objective: To explore the effectiveness of propeller facial artery perforator flap to repair the defect after resection of skin malignant tumor at upper lip.

Upper and lower lip soft tissue thicknesses differ in relation to age and sex / Grosores de los tejidos blandos de los labios superior e inferior difieren en relación con la edad y el sexo

This study was performed to determine age- and sex-related differences in lip thickness. Lateral cephalometric images of 220 healthy individuals were taken and the thicknesses of the upper and lower lips were measured. The measurements were performed in three different age groups. Our results indicate that the lower lip thickness, as well as the distance between the most anterior point of contact between the upper and lower lips and the most protruding point of the upper incisor teeth, differed between the two sexes. The lips of males were thicker than those of females. Receiver operating curve analysis was performed to determine the cutoff values to differentiate thickness between males and females. Our results showed that knowledge of upper and lower lips thickness in relation to age and sex may be beneficial to forensic anthropologists, to plastic and reconstructive surgeons, and to orthodontists for more detailed examination, effective treatment, and optimised outcomes.

Este estudio se realizó para determinar las diferencias en el grosor de los labios relacionadas con la edad y el sexo. Se tomaron imágenes cefalométricas laterales de 220 individuos sanos y se midió el grosor de los labios superior e inferior. Las mediciones se realizaron en tres grupos de edades diferentes. Nuestros resultados indicaron que el grosor del labio inferior, así como la distancia entre el punto más anterior de contacto, entre los labios superior e inferior y el punto más sobresaliente de los dientes incisivos superiores, difieren entre los dos sexos. Los labios de los hombres eran más gruesos que los de las mujeres. Se realizó un análisis de la curva de operación del receptor para determinar los valores de corte para diferenciar el espesor entre hombres y mujeres. Nuestros resultados demostraron que el conocimiento del grosor de los labios, superior e inferior, en relación con la edad y el sexo puede ser beneficioso para los antropólogos forenses, cirujanos plásticos y reconstructivos y para los ortodoncistas al momento de realizar un examen detallado, e implemantar un tratamiento más eficaz, alcanzando resultados optimizados.

Aesthetic repair of medial upper lip defects / 中华医学美学美容杂志

Objective To explore the aesthetic results of medial upper Iip repair for skin and soft tissue defects using local flap.Methods According to the location and the size of upper lip defect,the modified rhomboid flap of 60 ° above the defect was designed to repair the wound in philtrum;the O-L flap along philtral column to vermilion border was designed to cover the wound close to the peak and lateral to philtral column.Results Twenty-one postoperative patients that underwent pigmented nevus removal (12 female,9 male;ages 16-33 years) had defects in philtrum for 10 cases and close to the peak and philtral column for 11 cases.The diameter of the defect ranged from 0.5 cm to 1.0 cm.All flaps survived primarily without any complications and follow-up was for 1 to 18 months with excellent outcomes in all cases.All patients were satisfied with contour and functions.No pigmented nevus recurrence occurred.Conclusions The flap designed according to the aesthetic principle could be used to repair medial upper lip defect of medium-sized,which not only obtains functional reconstruction,but also satisfies aesthetic results,with aesthetic subunits saved and scar concealed.

Uso de la técnica quirúrgica de Bernard-Burow modificada en un paciente con carcinoma espinocelular del labio superior / Use of Bernard-Burow surgical technique modified in a patient with squamous-cell carcinoma of the upper lip

Se presenta el caso clínico de un paciente de 61 años de edad, con antecedentes de fumador activo, quien fuera remitido de su área de salud al Servicio de Cirugía Maxilofacial del Hospital Provincial Docente "Dr. Joaquín Castillo Duany" de Santiago de Cuba, por presentar una lesión en el borde bermejo del labio superior, cuyos exámenes clínico e histopatológico revelaron que se trataba de un carcinoma espinocelular. Durante el tratamiento quirúrgico se aplicó una modificación de la técnica de Bernard-Burow, que permitió evitar la pérdida de la subunidad correspondiente al filtrum y la asimetría de las comisuras labiales, resultantes del método tradicional

The case report of a 61 years patient is presented, with a history of active smoking who was referred from his health area to the Maxillofacial Surgery Service of "Dr. Joaquín Castillo Duany" Teaching Provincial Hospital in Santiago de Cuba, due to an injury in the red border of the upper lip whose clinical and histopathological exams revealed that it was a squamous-cell carcinoma. During the surgical treatment a modification of the Bernard-Burow technique was applied that allowed to avoid the loss of the subunit corresponding to the filtrum and the asymmetry of the labial corners, resulting from the traditional method

Comparison of predictors of difficult intubation

Context: Unanticipated difficult laryngoscopy and tracheal intubation always remain a primary concern for an anaesthesiologist as the failure to maintain a patent airway during induction of anaesthesia may lead to anaesthesia related morbidity and mortality. Aims: The aim of our study was to predict difficult intubation and to identify best predictor(s) among them and also to compare the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of various airway parameters.Airway parameters taken in our study were Modified Mallampati Classification (MMT), Thyromental Distance (TMD), Sternomental Distance (SMD), Interincisor Gap (IIG), Upper Lip Bite Test (ULBT), Degree of Neck Extension (DNE), Anterior Subluxation of Mandible (ASM) and Protruding Teeth (PT). Methods and Material: 350 patients of ASA Grade 1 and 2 scheduled for various elective surgeries under general anaesthesia were included in our study and were assessed preoperatively for different airway parameters. Intraoperatively all patients were classified as difficult and easy intubation group according to Cormack and Lehane laryngoscopic view. Clinical data of each test was collected, tabulated and analyzed to obtain the sensitivity, specificity, positive predictive value and negative predictive value. Results: The upper lip bite test had the highest sensitivity (80%); Anterior subluxation of mandible had highest specificity (99.06%) and both of above were most accurate tests. The overall incidence of difficult intubation was 8.57%. Conclusion: Upper lip bite test was the best predictor of difficult intubation and it should be included as a routine test along with Modified mallampati test in preanaesthetic evaluation.

Correcting the secondary bilateral cleft lip deformities using an innovative partial-thickness musculomucosal pedicle cross-lip flap / 中华医学美学美容杂志

Objective According to the fine artery anatomy of the lower lip, we developed an innovative partial-thickness myocutaneous flap based on the vascular network of the submucosal and subcutaneous layers of the lower lip.We attempted to treat the secondary bilateral cleft lip deformities using this innovative cross-lip flap.Methods From July 2009 to June 2015, this new technique was used in 98 patients with secondary bilateral cleft lip deformities.The central defects usually occurred in these patients.The defects were reconstructed partially or completely according to the severities of the defects.The operative procedures were as follows: The split flap was elevated from the posterior portion of the oris orbicularis muscle after the inferior labial arteries were divided.Then the partial-thickness flap was rotated 180 degrees horizontally and inverted 180 degrees upward to the upper lip defect.Results All 98 musculomucosal pedicle flaps were viable.The upper lips were reconstructed according to the severities.Conclusions This myocutaneous cross-lip flap with musculomucosal-pedicle has a more reliable blood supply, better flexibility and plasticity.It is an effective method for aesthetic reconstruction for the secondary bilateral cleft lip deformities.

Comparison and evaluation of various bedside tests to predict difficult endotracheal intubation.

Introduction: As difficult laryngoscopy is a multifactorial problem, therefore any preoperative assessment of difficult tracheal intubation should have high sensitivity and specificity and result in minimal false positive and false negative values. This study was conducted in an attempt to devise a method of predicting difficult intubation and to assess the reliability of six simple bedside tests to predict difficult intubation. Material and Methods: This double blind prospective study involved 100 adult patients posted for elective surgery under general anesthesia. The airways were assessed for modified Mallampati test, Thyromental Distance, Sternomental Distance, Inter incisor gap; Atlanto-Occipital joint extension and Upper Lip bite Test. The laryngoscopic view and difficulty of intubation were noted. The sensitivity, specificity, positive and negative predictive values were calculated. Results: No method either individual or in combination with others had 100% sensitivity. The Modified Mallampati test had 76% sensitivity. Upper Lip bite Test had 98.66% specificity. The combination of Modified Mallampati test and Inter incisor gap had 52% sensitivity and 86.66% specificity. Conclusion: The “composite intubation difficulty score” is an easy and reliable method of predicting difficult intubation.

Ascher’s syndrome: A rare case report.

An 18‑year‑old Indian girl with upper lip deformity presented with on and off painless swelling of her both upper eyelids for 3 years. Clinical evaluation revealed bilateral blepharochalasis narrowing of horizontal palpebral fissure, decreased outer intercanthal distance, iris coloboma, cleft soft palate, bifid uvula, sensorineural deafness and double upper lip. Clinical examination of the thyroid, thyroid hormone assay and ultrasonography revealed normal thyroid gland structure and function. Ascher’s syndrome was diagnosed. To our knowledge, this is the first reported case of Ascher’s syndrome associated with iris coloboma, heterochromia iridum, and narrowing of horizontal palpebral fissure and decreased outer intercanthal distance secondary to lengthening of lateral canthal ligament.

Application of upper-lip lifting procedure in perioral rejuvenation / 中华医学美学美容杂志

Objective To illustrate a method of lifting the upper-lip to alleviate the aging face,and to evaluate its effects and risks.Methods In the past two years,53 cases of overlong upper-lip were performed with this procedure.The recovery periods,lifted effects,side effects and the total satisfactions were evaluated.Results As for recovery periods,edema roughly reduced in 6-20 months,reddish scar faded in 1-11 months,expression restored in 2-8 months,and numbness disap peared from 4 to over 18 months.The lifted effects showed that 37 cases (78.7％) were satisfactory,7 cases (14.9％) of the lifting was not enough and still complained a long upper-lip,2 cases (4.2％) was ineffective,and 1 case (2.1 ％) considered an excessive lifting.The long term follow-up showed that 3 cases (6.4％) had obvious scar (visible at a distance of more than 1 m),14 cases (29.8％) had depression of columella/base of nostril alar or with increased exposure of nostril,3 cases (6.4 ％) had expansion or morphological changes of alar,6 cases (12.8％) had increased thickness of the upper lip and prominent vermilion tubercle,1 case (2.1％) had changes of expression,1 case (2.1％) had asymmetry,1 case (2.1％) had arching sagging,and 35 cases (74.5％) had numbness or insensitivity of upper-lip.Overall results showed very satisfied in 29 cases (61.7％),satisfied in 15 cases (31.9 ％) and dissatisfied in 3 cases (6.4 ％).Conclusions The technique for upper-lip lifting displays a significant effect with few complication.It is recommended for further clinical application.

Congenital midline sinus of the upper lip

A congenital lip sinus is a rare condition that has been reported to occur in both the upper and lower lips, either in isolation or in association with congenital deformities such as a cleft lip and palate in Van der Woude syndrome. The prevalence of lower lip sinuses has been estimated to be about 0.00001% of the white population. Upper lip sinuses are even more uncommon. To date, there have been several case reports of upper lip sinuses and fistulas, but no similar cases have been described in Singapore. We herein report a case of congenital upper lip sinus presenting as a recurring upper lip abscess and review the current literature on this condition.

Fechamento de fístula oronasal com retalho miomucoso labial superior / Closure of an oronasal fistula with a myomucosal upper lip flap

INTRODUÇÃO: A fístula palatina é a complicação mais frequente após palatoplastias e sua presença traz diversas implicações. Sua apresentação é diversificada e seu reparo pode ser difícil, o que se traduz na existência de uma diversidade de técnicas cirúrgicas descritas. OBJETIVO: Relatar a correção cirúrgica de fístula palatina anterior com retalho miomucoso labial superior, além de fazer uma breve revisão da literatura. RELATO DE CASO: Paciente submetido à correção de fissura palatina completa, apresentando, no pós-operatório mediato, fístula anterior de palato duro e processo alveolar, submetido à correção da fístula palatina oronasal com retalho miomucoso de lábio superior. O paciente evoluiu satisfatoriamente, sem complicações e sem recidiva da lesão após um ano de seguimento. CONCLUSÃO: A técnica em questão mostrou-se simples e eficiente, prestando-se à correção da fístula palatal anterior.

INTRODUCTION: Palatal fistula is the most common complication after palatoplasty, and its presence entails various implications. Its presentation is diverse and repair can be difficult, which is reflected in the existence of a numerous surgical techniques described for its treatment. OBJECTIVE: To report the surgical correction of palatal fistula with a myomucosal upper lip flap, along with a brief review of the literature. CASE REPORT: The patient underwent repair of complete cleft palate. At the immediate postoperative time, an anterior fistula of the hard palate and alveolar process was present and was subjected to a correction with an oronasal myomucosal upper lip flap. The patient progressed satisfactorily, without complications or lesion recurrence after 1 year of follow-up. CONCLUSION: The technique presented is a simple and efficient method for correction of an anterior palatal fistula.

The predictive value of five factors to the maternal difficulty airway / 实用医学杂志

Objective To research the most commonly used five method to evaluated the difficulty airway , and compare which methods were more suited for the pregnant woman in general anesthesia. Methods 214 patients with full-term pregnancy who requested emergency or elective caesarean-section were assigned. During the pre-anesthetic visit,we evaluated patients from Mallampati score, thyromental distance, body mass index (BMI), inter-incisor gap, and upper lip bite test. After endotracheal intubation ,patients were divided into 2 groups based on Cormack classification. Results Five ways sensitivity descending order were upper lip bite test (79.5%)、Mallampati score (76.9%)、BMI (56.4%)、inter-incisor gap (51.3%)、thyromental distance (35.9%); specificity descending order were upper lip bite test (93.1%)、Mallampati scores (86.3%)、inter-incisor gap (85.1%)、thyromental distance (76.6%)、BMI (62.3%). Conclusions In pregnant women ,Mallampati score and the upper lip bite test are the better indicators to predict difficult airway.