Analysis of anterior soft tissue thickness using ultrasonogram, body mass index and neck circumference in predicting difficult intubation

Ravindran, B; Pgimsr, K.K. Nagar; Magesh, V Murali; Vignesh, B; Kumar, K Vinoth

doi:10.26611/1015718

MIJOANS

2018

DOI: 10.26611/1015718

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Analysis of anterior soft tissue thickness using ultrasonogram, body mass index and neck circumference in predicting difficult intubation

B Ravindran¹,

K.K. Nagar Pgimsr²,

V Murali Magesh³

et al.

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2023

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“…Ultrasonography can yield detailed anatomic information and may assist other methods in the prediction of a difficult airway. The anterior soft tissue thickness of the neck can significantly predict difficult intubations and can be an important aid for an anesthesiologist [4].…”

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confidence: 99%

Accuracy of Preoperative Ultrasonographic Airway Assessment in Predicting Difficult Laryngoscopies in Adult Patients

Bhagavan¹,

Nelamangala²

2023

Cureus

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Background and objectivesPresently, neck ultrasonography is used as a tool to predict a difficult airway. There are no standardized ultrasonographic criteria that help to predict a difficult airway. This study aims to ultrasonographically assess the anterior neck soft tissue thickness preoperatively based on two parameters-the minimal distance from the hyoid bone to skin (DSHB) and the distance from the skin to the epiglottis midway between the hyoid bone and thyroid cartilage (DSEM)-and find out whether these parameters can predict a difficult airway in adults by correlating with the Cormack-Lehane (CL) grading. Background and objectivesAfter obtaining ethical committee clearance and patient consent, we conducted this study on 96 patients aged between 18 and 60 years, belonging to American Society of Anesthesiologists (ASA) classes one and two, who were admitted for elective surgery under general anesthesia with endotracheal intubation to RL Jalappa Hospital and Research Centre, Tamaka, Kolar, from January 2020 to May 2021. The exclusion criteria were patients with anticipated difficult airway cases, such as obesity, pregnancy, head and neck anatomical pathologies, maxillofacial anomalies, and edentulous patients. The sonography of the airway was first performed preoperatively by an anesthesiologist along with standard clinical tests such as Mallampati (MP) grading. The sonography included two parameters: DSHB and DSEM. The patients were later classified as having easy or difficult laryngoscopy based on USG criteria from the available literature. A DSHB value of greater than 0.66 cm was predicted to be a difficult airway, and less than 0.66 cm was predicted to be easy. A DSEM value greater than 2.03 cm was predicted to be a difficult airway, and less than 2.03 cm was predicted to be easy.After induction of anesthesia, another experienced anesthesiologist performed direct laryngoscopy in the sniffing position with an appropriate-sized Macintosh blade and CL grades. CL grades I and II were considered to be easy laryngoscopies.The quantitative data were presented by mean SD and confidence interval (CI). The qualitative data were presented in percentages, and p-values less than 0.05 were considered statistically significant. To determine the discriminative power of individual tests, the receiver operating characteristic curve and the area under the curve with a 95% confidence interval was noted. ResultsThe two USG parameters DSHB and DSEM may be used to predict difficult laryngoscopy in adult patients, as both have very strong statistical significance. Of the two parameters, DSHB seems to have a better diagnostic value for predicting a difficult airway in our study, as supported by the area under the curve (AUC) of 97.4% compared to DSEM with an AUC of 88.8%. DSHB has better sensitivity (100%), and DSEM has better specificity (89.77%). ConclusionOur study showed that DSHB and DSEM may aid in predicting difficult laryngoscopies, as a strong statistical significance was present between sonographic measurements and CL ...

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confidence: 99%

Accuracy of Preoperative Ultrasonographic Airway Assessment in Predicting Difficult Laryngoscopies in Adult Patients

Bhagavan¹,

Nelamangala²

2023

Cureus

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Analysis of anterior soft tissue thickness using ultrasonogram, body mass index and neck circumference in predicting difficult intubation

Cited by 1 publication

References 4 publications

Accuracy of Preoperative Ultrasonographic Airway Assessment in Predicting Difficult Laryngoscopies in Adult Patients

Accuracy of Preoperative Ultrasonographic Airway Assessment in Predicting Difficult Laryngoscopies in Adult Patients

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