The performance of ultrasound-based quantification of the hyomental distance ratio in predicting difficult airway in anaesthesia

Petrișor, Cristina; Szabó, Róbert; Constantinescu, Cătălin; Prie, Adrian; Trancă, Sebastian; Hagău, Natalia

doi:10.1097/eja.0000000000000849

Cited by 12 publications

(24 citation statements)

References 5 publications

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“…The sonographic assessment of the airway has encouraging results in predicting difficult laryngoscopy [9]. HMDR obtained by ultrasonography can be used for difficult airway prediction [10]. Because of the wide variability in clinical studies, ultrasound evaluation of the HMDR might be of interest, especially that the scanning technique is simple.…”

Section: Imaging Studiesmentioning

confidence: 99%

“…Because of the wide variability in clinical studies, ultrasound evaluation of the HMDR might be of interest, especially that the scanning technique is simple. With a cutoff of 1.24, the sensitivity of ultrasound-measured HMDR was 86-100%, while the specificity was 72-90.5% in the non-obese and obese populations [10,11]. Using ROC analysis, Koundal et al found a cutoff of 1.08-1.085 for HMDR echo , with 65-75% sensitivity and 77-85% specificity [9,12].…”

Section: Imaging Studiesmentioning

confidence: 99%

“…The diagnostic accuracy of this parameter varied widely in subsequent studies, suggesting that evaluation of clinical parameters might be operator-dependent or that there might be difficulties regarding the palpation of the hyoid bone in certain patients [4][5][6][7][8]. In the last years, ultrasound measurements were applied for the hyomental distance ratio (HMDR echo ), also with variable sensitivity and specificity [9][10][11][12][13]. However, until now, each of the previous studies on HMDR focused on a single technique of measurement, either clinical or ultrasonographical, and no study compared the two.…”

Section: Introductionmentioning

confidence: 99%

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Clinical versus Ultrasound Measurements of Hyomental Distance Ratio for the Prediction of Difficult Airway in Patients with and without Morbid Obesity

et al. 2020

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Purpose: To describe the correlation between clinically measured hyomental distance ratio (HMDR clin ) and the ultrasound measurement (HMDR echo ) in patients with and without morbid obesity and to compare their diagnostic accuracy for difficult airway prediction. Methods: HMDR clin and HMDR echo were recorded the day before surgery in 160 consecutive consenting patients. Laryngoscopy was performed by a skilled anesthesiologist, with grades III and IV Cormack-Lehane being considered difficult views of the glottis. Linear regression was used to assess the correlation between HMDR clin and HDMR echo and receiver operating curve analysis was used to compare the performance of the two for predicting difficult airway. Results: The linear correlation between HMDR clin and HDMR echo in patients without morbid obesity had a Pearson coefficient of 0.494, while for patients with morbid obesity this was 0.14. A slightly higher area under the curve for HMDR echo was oberved: 0.64 (5%CI 0.56-0.71) versus 0.52 (95%CI, 0.44-0.60) (p = 0.34). Conclusion: The association between HMDR clin and HDMR echo is moderate in patients without morbid obesity, but negligible in morbidly obese patients. These might be explained by difficulties in palpating anatomical structures of the airway.

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Section: Imaging Studiesmentioning

confidence: 99%

Section: Imaging Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical versus Ultrasound Measurements of Hyomental Distance Ratio for the Prediction of Difficult Airway in Patients with and without Morbid Obesity

et al. 2020

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“…In the non-obese patients ANS measurements at the levels of the hyoid bone and epiglottis might discriminate between easy and difficult laryngoscopy [15]. Reported sensitivities and specificities for ANS measured at different levels vary considerably among studies [7,12,18,19,22,24]. These clinical studies are not fully comparable and each includes only modest numbers of patients.…”

Section: Anterior Neck Soft Tissue Thicknessmentioning

confidence: 99%

“…Andruszkiewicz et al have found a modest sensitivity of 42.9% for difficult airways [11]. Recently, in three published studies, sensitivities have been appreciated to be higher [23,24,25].…”

Section: Hyomental Distances and Derived Ratiosmentioning

confidence: 99%

Preoperative difficult airway prediction using suprahyoid and infrahyoid ultrasonography derived measurements in anesthesiology

et al. 2019

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Airway management is one of the most important skills in everyday practice of anesthesia. Improper airway management might contribute to significant morbidity and mortality. In some patients, clinical parameters do not anticipate all difficulties related to airway management. Ultrasonography (US) might confer a potential screening tool for difficult airway. Suprahyoid and infrahyoid US measurements have been investigated for difficult airway prediction in anesthesiology. The most extensively investigated parameter was the anterior neck soft tissue thickness measured at different levels: anterior to the hyoid bone, epiglottis and vocal cords commissure. Hyomental distances measured with the head placed in neutral, sniffing or maximal hyperextended position and the derived hyomental distance ratios have also been evaluated for difficult airway prediction. For the evaluation of the tongue, measurements such as thickness, cross-sectional area, width, volume and tongue-to-oral cavityratio can be used. Thus, anesthesiologists have many available potential US measurements, which could provide information regarding airway anatomy during the preoperative airway assessment and could serve as potential screening parameters for difficult airway. Still, we do not yet know which of these provides optimal predictive accuracy and larger sample size studiesare required to validate their use in the preoperative evaluation of the airway.

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A Scoping Review of Ultrasonographic Techniques in the Evaluation of the Pediatric Airway

Burton

Bhargava

2023

J of Ultrasound Medicine

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Point of care ultrasound is making rapid advancements in pediatrics, and ultrasonographic assessment of the airway is being employed in many specialties such as the pediatric, cardiac, and neonatal intensive care units, emergency department, pulmonary clinic, and the perioperative setting. This scoping review provides a technical description of image acquisition and interpretation, accompanying ultrasound images of the hallmark airway applications in pediatrics, and supporting evidence when available. We describe and illustrate ultrasound‐determined endotracheal tube (ETT) sizing, ETT placement and depth confirmation, vocal fold assessment, prediction of post‐extubation stridor, difficult laryngoscopy prediction, and cricothyrotomy guidance. This review aims to provide the descriptions and images necessary to learn and apply these skills at the point of care in the pediatric patient.

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The performance of ultrasound-based quantification of the hyomental distance ratio in predicting difficult airway in anaesthesia

Cited by 12 publications

References 5 publications

Clinical versus Ultrasound Measurements of Hyomental Distance Ratio for the Prediction of Difficult Airway in Patients with and without Morbid Obesity

Clinical versus Ultrasound Measurements of Hyomental Distance Ratio for the Prediction of Difficult Airway in Patients with and without Morbid Obesity

Preoperative difficult airway prediction using suprahyoid and infrahyoid ultrasonography derived measurements in anesthesiology

A Scoping Review of Ultrasonographic Techniques in the Evaluation of the Pediatric Airway

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