Short Neck, a new criterion for airway assessment A pilot, cohort single blind study

Abstract

Purpose Short Neck is a term used by anesthesiologists to describe one of the risk factors for difficult airway management. However, the term Short Neck is very subjective and has not been standardized. We attempt to quantify Short Neck.Methods A pilot prospective single blinded study was conducted at Hamad General Hospital, Doha, Qatar between March 2018 and October 2018. 97 adult patients scheduled for elective surgery under general anesthesia were recruited. Measurements of airway assessment, including neck length, were documented prior to anesthesia. The operators (anesthesiologists) were blinded. Intubation Difficulty Scale was used. All data were documented and analysed afterwards. Patients were of three groups according to Intubation Difficulty Scale (IDS): Group A: IDS 0, Group B: IDS >0 - ≤5 and Group C: IDS >5.Results Five patients (5.2%) with intubation difficulty score >5 have a mean neck length 7.6 cm. Short Neck was found to have a significant p value 0.022 within the three groups.Conclusions Patient's features relevant to airway assessment are rather difficult to quantify. This is the first reported attempt to obtain an objective value for Short Neck in routine airway assessment.

Novel and pragmatic exploration of variation in glottic parameters in non-parallel versus parallel vocal cord CT planes with potential reporting pitfalls

“…We found significant negative correlation between BMI versus neck length and neck length versus angle, demonstrating that unformatted images of obese patients with short necks were more prone to show up false glottic anatomy due to higher angulation between two planes or steeper VC in them ( Fig 10 ). Thus, radiologist and laryngologist should opt meticulous approach to assess CT necks of these patients as short necks without CT reformation not only compromise radiological anatomy but laryngoscopic evaluation of airway as well [ 32 ].…”

“…A total of 127 patients' files were scrutinized for eligibility criteria, out of which 32 were withdrawn from study leaving 95 patients (42 males, 53 females) to be further analysed. Excluded patients (32) were having laryngeal mass, neck mass with compression on larynx, subglottic stenosis and missing data (n = 14, 11, 5 and 2 respectively). Means (range, standard deviation) of aNL, age, height, weight and body mass index (BMI) of patients were 57.49 cm (10.5-100.8, ±19.1) 46.…”

Anesthetic and Airway Management in a Pediatric Patient with Morquio Syndrome: A Case Report

“…The patient had a short neck which may limit neck movement and make visualization of the glottic opening challenging during laryngoscopy. 7 Beyond what can be assessed during routine physical examination, GAGs may also infiltrate pharyngeal and laryngeal structures, causing narrowing of the upper airway, and this may be suggested by the patient’s observed sleep-disordered breathing. Additionally, keratan sulfate, the predominant GAG in MPS IV, has a pre-disposition to accumulate in the trachea, especially the hyaline cartilage of the anterior tracheal rings, leading to tracheal narrowing and tracheomalacia.…”