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BACKGROUND: Airway management problems may arise whenintubating patients with goitre scheduled for thyroidectomy.Goitres are not uncommon in sub-Saharan Africa, thyroidectomybeing the main treatment. The aim of this study was to determineincidences of difficult intubation (DI), failed intubation (FI)andpredictors of DI using a modified intubation difficulty score(IDS).METHODS: One hundred and twenty-five consenting patientswith goitre scheduled for thyroidectomy were recruited. Goitre-related factors (GRF) of duration of illness, diagnosis, neckcircumference, tracheal deviation and narrowing and retrosternalextension were recorded as well as Mallampati classification andBMI. At intubation, modified IDS was determined for eachpatient. Patients with modified IDS ≤ 5 were categorized as easyintubation group (E), and those with modified IDS >5 werecategorized as difficult intubation group (D). The GRF of allpatients in group D were compared with matched patients ingroup E.RESULTS: Incidence of DI was 13.6% with 2 (1.6%) cases offailed intubation. Comparing groups D and E, duration of illnesswas 4.28 ± 3.78 years in group D versus 7.44 ± 7.63 years groupE, p = 0.1353. Neck circumference was 41.42 ±5.30 cm in groupD versus 37.43±2.68 cm in group E, p = 0.0200. Trachealdeviation, narrowing and retrosternal extension, and surgicaldiagnosis were not significantly different among both groups.CONCLUSION: Incidence of DI was 13.6% and that of FI was1.6%. Neck circumference was found to be a predictor of difficultintubation in goitre patients scheduled for thyroidectomy usingthe modified IDS.