Orthognathic surgery involves relocation of the mandible, and potential postoperative complications must be realistically discussed by the surgeons and patients, such as whether the temporomandibular joint will exhibit clicking symptoms, whether mandibular mobility and mouth opening will recover, and whether abnormal lip sensation will occur.
In case of too wide of a mouth opening, or excessive mobility of the jaw and mandible deviation during opening (with excluded suspicion of subluxation), the exercises are limited, and straightening of the opening pathway are recommended.
The practical use of an assessment that requires a sitting patient, placing fingers in a patient's mouth and testing the mobility of the neck are all questionable in the pre-hospital trauma patient.
When these conditions are not met, for example in poor tissue mobility, limited mouth opening, or enlarged tongue, the failure rate of intubation with conventional direct laryngoscopy increases [ 3- 5].
Feeding on land required more head mobility to move the mouth to food, and the tongue developed to promote the manipulation of food once in the mouth.
Traditional external airway exam features, such as thyromental distance, mouth opening, Mallampati score, cervical spine mobility, and neck circumference were not included as potential confounders for two reasons.
But how in the world can a multicellular, metabolic slowpoke overcome the costs of reduced mobility and essentially more mouths to feed when competing with diverse single-celled organisms capable of gobbling up resources at a much faster rate?
Furthermore, cervical mobility, articulation of speech and mouth opening are meaningful.
The main predictors of difficult intubation were related to the patient (Mallampati score III or IV, obstructive sleep apnea syndrome, reduced mobility of cervical spine, limited mouth opening), the pathology (coma, severe hypoxia) and the operator (non¬anesthesiologist) (Table 1).
