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1

ŞENGEL, Necmiye, Gülsüm KARABULUT, M. Emin TOPRAK, and Arzu Esen TEKELİ. "Predictive Values of LEMON and LEON Scores in Elective Oral and Maxillofacial Surgery- Correlation with Intubation Difficulty Scale." Yüksek İhtisas Üniversitesi Sağlık Bilimleri Dergisi 3, no. 2 (2022): 33–38. http://dx.doi.org/10.51261/yiu.2022.00045.

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Introduction: Airway management can be a major concern, due to the possibility of encountering difficult ventilation and intubation. The Modified Intubation Difficulty Scale (MIDS) is a quantitative scale that can objectively compare nasotracheal intubation. LEMON method which consists of following assessments; Look-Evaluate-Mallampati-Obstruction-Neck mobility and modified LEMON scores (LEON) are popular scoring systems described for airway management due to their easy usability. We aimed to evaluate usability of the LEMON and LEON scores in patients who underwent oral and maxillofacial surgery by studying correlation between each score and the MIDS. Materials and Methods: The records of 72 patients were reviewed retrospectively. At the pre-anesthetic evaluation; airway assessments were recorded according to LEMON, LEON scores; MIDS were recorded after intubation. Patients were allocated into two groups: Non-difficult (NonD; MIDS ≤5) and Difficult (D; MIDS >5). Correlations between scores were analyzed using Spearman’s rank correlation. Receiver operating characteristic (ROC) curve plots were used to determine possible cut-off values; specificity, sensitivity, negative-predictive values for LEON and LEMON scores. In all analyses, p<0.05 were considered statistically significant. Results: LEMON and LEON scores were correlated with the MIDS. Analysis of ROC curve plots revealed 2 cut-off values (≥4 and ≥5) for LEMON; 1 cut-off value (≥4) for LEON score. Among the scores, LEMON (≥4), LEON had the highest sensitivity and negative-predictive values (both 100%); LEON showed higher specificity than the LEMON (≥4) (96.7% vs 91.8%). LEMON (≥5) had the highest specificity (98.4%) but the lowest sensitivity (90.4%), negative-predictive value (90.9%) among the group. Conclusion: LEON scores ≥4 can be effectively used with 100% sensitivity, 96.7% specificity and, 100% negative-predictive-value for predicting difficult airway and intubation in elective maxillofacial surgeries. Keywords: Oral and maxillofacial surgery, airway assessment, LEON Score, LEMON Score, Modified Intubation Difficulty Scale
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2

Gazzaniga, Michael S. "Leon Festinger." Perspectives on Psychological Science 1, no. 1 (March 2006): 88–94. http://dx.doi.org/10.1111/j.1745-6924.2006.t01-3-.x.

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3

Baird, Robert M. "Leon Jaworski." Social Philosophy Today 1 (1988): 167–79. http://dx.doi.org/10.5840/socphiltoday1988123.

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4

Hirst, L. G. A. G. S. "Leon Gerlis." BMJ 347, oct15 6 (October 15, 2013): f5879. http://dx.doi.org/10.1136/bmj.f5879.

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5

McIntyre, Laurence C., John A. Leavitt, and Michael D. Scadron. "Leon Blitzer." Physics Today 58, no. 7 (July 2005): 79–80. http://dx.doi.org/10.1063/1.2012479.

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6

Burkill, H., C. Hooley, W. Ledermann, and Hazel Perfect. "Leon Mirsky." Bulletin of the London Mathematical Society 18, no. 2 (March 1986): 195–206. http://dx.doi.org/10.1112/blms/18.2.195.

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7

Skrebitskii, V. "Leon Voronin." Neurophysiology 36, no. 2 (March 2004): 168. http://dx.doi.org/10.1023/b:neph.0000042569.87208.73.

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8

Robinson, Jessica. "Leon Robinson." BMJ 335, no. 7616 (August 23, 2007): 405.5. http://dx.doi.org/10.1136/bmj.39300.730995.be.

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9

Bullamore, T. "Leon Schwartzenberg." BMJ 327, no. 7422 (November 1, 2003): 1052. http://dx.doi.org/10.1136/bmj.327.7422.1052.

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10

Mohn, Kathy. "Where's Leon?" Journal of Dance Education 8, no. 3 (July 2008): 104. http://dx.doi.org/10.1080/15290824.2008.10387369.

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11

Palmer, Bryan D. "Leon Trotsky." Socialism and Democracy 30, no. 1 (January 2, 2016): 196–200. http://dx.doi.org/10.1080/08854300.2016.1144321.

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12

Wieseltier, Leon. "Leon Wieseltier." Dissent 57, no. 1 (2010): 40–42. http://dx.doi.org/10.1353/dss.2010.0003.

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13

Snyder, Alison. "Leon Eisenberg." Lancet 375, no. 9710 (January 2010): 194. http://dx.doi.org/10.1016/s0140-6736(10)60082-7.

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14

Thatcher, Ian D. "Leon Trotsky." Revolutionary Russia 28, no. 2 (July 3, 2015): 211–12. http://dx.doi.org/10.1080/09546545.2015.1087957.

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15

Lagnado, Leon. "Leon Lagnado." Current Biology 23, no. 5 (March 2013): R181—R183. http://dx.doi.org/10.1016/j.cub.2013.01.032.

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16

Berci, George. "Leon Morgenstern." Surgical Innovation 20, no. 5 (September 13, 2013): 434. http://dx.doi.org/10.1177/1553350613503607.

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17

Lee, Yung K., Thomas Fulton, and Gordon Feldman. "Leon Madansky." Physics Today 54, no. 2 (February 2001): 79–80. http://dx.doi.org/10.1063/1.1359720.

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18

Stafford, N. "Leon Eisenberg." BMJ 339, no. 18 3 (November 18, 2009): b4615. http://dx.doi.org/10.1136/bmj.b4615.

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19

Lightman, Bernard. "Leon Blum." History of European Ideas 7, no. 2 (January 1986): 190–92. http://dx.doi.org/10.1016/0191-6599(86)90074-4.

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20

Blaisdell, F. William. "Leon Goldman." Archives of Surgery 138, no. 12 (December 1, 2003): 1393. http://dx.doi.org/10.1001/archsurg.138.12.1393.

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21

Denis, Lee. "Leon Costermans." Peninsula Field Naturalists' Club Newsletter (2023:Dec) (December 2023): 15. http://dx.doi.org/10.5962/p.381602.

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22

Millard, Ruth. "Leon Morris' library comes to the Leon Morris Library." ANZTLA EJournal, no. 54 (May 1, 2019): 10. http://dx.doi.org/10.31046/anztla.v0i54.1264.

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23

David and Lilac Hadar. "Leon Pinsker’s Ghosts." Shofar: An Interdisciplinary Journal of Jewish Studies 39, no. 1 (2021): 141–46. http://dx.doi.org/10.1353/sho.2021.0012.

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24

Roe, David, and Barbara Pascarel. "Leon-Paul Fargue." Modern Language Review 96, no. 3 (July 2001): 838. http://dx.doi.org/10.2307/3736799.

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25

Gunter, Susan Elizabeth. "Ponce de Leon." College English 58, no. 2 (February 1996): 217. http://dx.doi.org/10.2307/378466.

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26

Dripps, Donald. "Living with Leon." Yale Law Journal 95, no. 5 (April 1986): 906. http://dx.doi.org/10.2307/796377.

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27

Duke, Steven. "Making Leon Worse." Yale Law Journal 95, no. 7 (June 1986): 1405. http://dx.doi.org/10.2307/796563.

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28

Fink, Leon. "Leon Fink Responds." American Historical Review 96, no. 2 (April 1991): 429. http://dx.doi.org/10.2307/2163217.

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29

Cole, Barry L. "Leon F Garner." Clinical and Experimental Optometry 86, no. 2 (March 2003): 127–30. http://dx.doi.org/10.1111/j.1444-0938.2003.tb03071.x.

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30

Leon, Andrew C. "Dr Leon Replies." Journal of Clinical Psychiatry 72, no. 08 (August 15, 2011): 1157. http://dx.doi.org/10.4088/jcp.11lr07077a.

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31

Riain, Mícheál Ó., and Donal Nevin. "Leon na Cosmhuintire." Comhar 58, no. 2 (1999): 27. http://dx.doi.org/10.2307/25573744.

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32

Dodd, David C., and Susan C. Kahler. "Leon Z. Saunders." Veterinary Pathology 46, no. 4 (July 2009): 561–62. http://dx.doi.org/10.1177/030098580904600401.

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33

Chernyshev, Aleksandr L., Alexei A. Maradudin, Steven R. White, and Clare Yu. "Douglas Leon Mills." Physics Today 65, no. 8 (August 2012): 62. http://dx.doi.org/10.1063/pt.3.1688.

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34

Appel, Jeffrey A., and Daniel Kaplan. "Leon Max Lederman." Physics Today 72, no. 1 (January 2019): 62. http://dx.doi.org/10.1063/pt.3.4118.

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35

Stein, Martin T. "Leon Eisenberg Remembered." Journal of Developmental & Behavioral Pediatrics 31, no. 1 (January 2010): 81. http://dx.doi.org/10.1097/dbp.0b013e3181c8ccaa.

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36

Nowick, Arthur, and W. W. Havens. "Shirley Leon Quimby." Physics Today 39, no. 11 (November 1986): 119–21. http://dx.doi.org/10.1063/1.2815223.

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37

Rollin, H. R. "Edgar Leon Udwin." BMJ 326, no. 7380 (January 11, 2003): 107k—107. http://dx.doi.org/10.1136/bmj.326.7380.107/k.

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38

Nierenberg, Andrew A. "Andrew C Leon." Neuropsychopharmacology 37, no. 13 (November 13, 2012): 2890. http://dx.doi.org/10.1038/npp.2012.201.

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39

Nicholls, Mark. "Martin Leon MD." European Heart Journal 37, no. 47 (December 14, 2016): 3486–87. http://dx.doi.org/10.1093/eurheartj/ehw531.

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40

Conners, C. Keith. "Leon Eisenberg Remembered." Journal of Attention Disorders 13, no. 5 (February 26, 2010): 553–54. http://dx.doi.org/10.1177/1087054709356934.

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41

Oransky, Ivan. "Leon J Thal." Lancet 369, no. 9571 (April 2007): 1424. http://dx.doi.org/10.1016/s0140-6736(07)60655-2.

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42

Fitchen, Douglas B., Neil W. Ashcroft, and John Silcox. "Paul Leon Hartman." Physics Today 59, no. 3 (March 2006): 89–90. http://dx.doi.org/10.1063/1.2195328.

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43

Tempany, Clare, Terrence Demos, Mary Olson, and Richard Cooper. "Leon Love, MD." Radiology 252, no. 3 (September 2009): 933. http://dx.doi.org/10.1148/radiol.2523092528.

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44

Galasko, Douglas R. "Leon Thal, MD." Alzheimer Disease & Associated Disorders 21, no. 2 (April 2007): 73–76. http://dx.doi.org/10.1097/wad.0b013e31806863b6.

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45

Shafer, Byron E. "Leon D. Epstein." PS: Political Science & Politics 39, no. 04 (September 29, 2006): 937–38. http://dx.doi.org/10.1017/s1049096506231226.

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46

Montague, Stephen. "Rediscovering Leon Theremin." Tempo, no. 177 (June 1991): 18–23. http://dx.doi.org/10.1017/s0040298200013528.

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In the early 1920s and 30s a strange electronic instrument found its way from Russia into some of the more fashionable ballrooms, night clubs, and concert halls in Europe and America. This exotic new invention, called the ‘theremin’ or ‘thereminvox’, caused a considerable stir. Part of the interest was its unusual sound (like a musical saw mated with a light soprano), but its most dramatic feature was that the performer never actually touched the instrument. He or she simply waved graceful hands near the two antennae (one set vertically, the other looped horizontally) to coax out seamless, melifluous melodies. The proximity of the right hand to the vertical antenna changed the ultrasonic electromagnetic field, thus changing the pitch over about a six-octave range. The left hand (or sometimes a foot pedal) controlled the volume. By gently shaking the right hand at the antenna a vibrato could be achieved, giving performances a little more musical (not to mention choreographic) interest. Fashionable women dressed in long gowns seemed to be favourite photographic subjects of the period as performers, as well as the inventor himself, poised ‘playing the rods’ in full dress tails, arms outstretched like a great conductor–or perhaps sorcerer.
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47

Cavanaugh, Laura. "Lessons from Leon." Disaster Medicine and Public Health Preparedness 8, no. 1 (February 2014): 1–2. http://dx.doi.org/10.1017/dmp.2014.20.

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48

Pollack, Erwin. "Isaac Leon Kandel." Prospects 23, no. 3-4 (September 1993): 775–87. http://dx.doi.org/10.1007/bf02195149.

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49

Park, Adrian E., and Lee Swanstrom. "Dr Leon Morgenstern." Surgical Innovation 20, no. 5 (October 2013): 433. http://dx.doi.org/10.1177/1553350613503604.

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50

Gorenstein, Paul, and Harvey Tananbaum. "Leon Van Speybroeck." Physics Today 56, no. 9 (September 2003): 78–79. http://dx.doi.org/10.1063/1.1620845.

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