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Aims: Narrowing of the upper airway during sleep causes snoring, hypoventilation and decreased oxygenation of the brain with recurrent arousal from sleep and a cascade of excessive daytime sleepiness, poor concentration in class and undesirable academic performance. This study determined the prevalence of day time sleepiness among students in secondary schools in Ibadan and establishes its association with body mass index, tonsil size, Mallampati score, and academic performance. Study Design: A prospective, cross sectional community based study. Place and Duration of Study: Ibadan town, Nigeria between August 2013 and July 2014. Methodology: This school-based cross-sectional study recruited the students by systematic random sampling technique. The participants answered an interviewer assisted structured questionnaire and had clinical examination for structural abnormalities of the oropharynx, Mallampati score, tonsillar grade and the BMI. The academic performances were determined using the overall mean average score of all the subjects offered during the first and second term of the academic session. The test of association between daytime sleepiness and other variables were determined. Statistical analysis of the data was done with Statistical Package for Social Sciences (SPSS) version 16. Results: There were 493 participants consisting 262 (53.1%) males and 231(46.9%) females (M: F ratio of 1.1:1), the mean age was 12.6 years + 2.6 (range = 9-17 years) and the mean BMI was 22.60 kg/m2±3.0 (range= 15.7 - 35.2 kg/m2). Daytime sleepiness was encountered in 56 (11.4%) of the students, this was association with high Mallampati score (p < 0.001), high BMI (p < 0.001), but had no association with academic performance (p = 0.54), tonsillar enlargement (p = 0.35), gender (0.82) and overnight sleeping duration (p = 0.21). Conclusion: The prevalence of daytime sleepiness among the secondary school students was 11.4%, and had no associated with academic performance. High BMI and Mallampati score were the significant risk factors identified.
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Objective To evaluate the effects of various head and neck postures and phonation on oropharyngeal view(Mallampati score),and ex-plore the correlation with laryngoscopic view tested by the improved Cormach-Lehane score(MCLS). Methods Following the local ethics commit-tee approval and patients′informed consent to anesthesia,124 patients were enrolled for this study. Prior to anesthesia,these patients were placed in supine position with various head and neck positions for oropharyngeal structures visualization and evaluation,including two head positions(neu-tral and full extension),two tongue positions(in and out),and with and without phonation,according to the modified Mallampati test score(MMT). Following induction,laryngoscopic view scores according to MCLS were recorded,then the sensitivity,specificity,positive and negative predictive value and accuracy of the various MMT scores were calculated. Correlation coefficient(r)of MMT scores with MCLS were also studied. Results Mallampati score was decreased in all the postures of head full extension,tongue outside and phonation,which makes oropharyngeal structures to be better visualized. There is no correlation between MMT scores and MCLS. The sensitivity,specificity,positive and negative predictive value and accu-racy of the various MMT scores is most satisfied in the posture of head full extension,tongue outside and phonation. Conclusion During airway as-sessment in supine position,the best posture is head full extension,tongue outside and phonation.
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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.
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OBJECTIVES: We wanted to evaluate whether the presence of nasal obstruction makes a change on the association between the modified Mallampati score and the severity of sleep-disordered breathing (SDB) and the sleep quality. METHODS: Polysomnography (PSG), the modified Mallampati score (MMS), the body-mass index, and a questionnaire about nasal obstruction were acquired from 275 suspected SDB patients. The subjects were divided into two groups according to the presence of nasal obstruction. The clinical differences between the two groups were evaluated and the associations between the MMS and PSG variables in each group were also assessed. RESULTS: Significant correlations were found between the MMS and many PSG variables, including the apnea-hypopnea index, the arousal index and the proportion of deep sleep, for the patients with nasal obstruction, although this was not valid for the total patients or the patients without nasal obstruction. CONCLUSION: The severity of SDB and the quality of sleep are well correlated with the MMS, and especially for the patients with nasal obstruction. The MMS can give more valuable information about the severity of SDB when combined with simple questions about nasal obstruction.