Stop-Bang Combined with Flexible Laryngoscopy Predicts Difficult Intubation in Patients With Obstructive Sleep Apnea

Background: Patients with ear-nose-and-throat (ENT) pathology often suffer from obstructive sleep apnea (OSA). This syndrome has been associated with both laryngeal pathology and difficult intubation (DI). The aim of our research was to prove that the STOP-BANG score for the detection of OSA can be used as a prediction score for DI and to define the most specific way to use it preoperatively.

Methods: We included 100 patients who were being prepared for microscopic laryngeal surgery. Flexible laryngoscopy and anesthesiologic exams were performed preoperatively. The STOP-BANG score, modified Mallampati score, and demographic data were provided during the interview. The difficulty of intubation was determined according to the intubation difficulty scale (IDS).

Results: According to IDS, there were 33% of DIs in our study. Age, weight, height, and body mass index (BMI) did not show statistical significance when it comes to DI. The Modified Mallampati score showed a statistical connection to intubation; however, there was an absence of its connection to OSA. Independently, the STOP-BANG score showed statistical significance when it comes to DI with an AUC of 0.660, while when combined with flexible laryngoscopy, its AUC improves to 0.824. We have provided the cut-off value for the STOP-BANG score of 3.50, which is specific for laryngology.

Conclusion: The STOP-BANG score can be used for the prediction of a difficult airway in laryngology if used in combination with flexible laryngoscopy.

Cite this article as: Marković D, Milisavljević D, Nikolić N, et al. Stop-bang combined with flexible laryngoscopy predicts difficult intubation in patients with obstructive sleep apnea. Balkan ORL-HNS 2024;1(3):88-93.