Comparison of Focused Upper Airway Ultrasonographic and Anthropometric Measurements for Predicting Difficult Intubation: A Prospective Observational Study.
Hyoid-skin distance is associated with difficult laryngoscopy, with only modest predictive accuracy
Comparison of Focused Upper Airway Ultrasonographic and Anthropometric Measurements for Predicting Difficult Intubation: A Prospective Observational Study.
The prediction of difficult laryngoscopic view remains an important component of preoperative airway assessment.
This study aimed to evaluate the diagnostic accuracy of focused upper airway ultrasonographic and conventional anthropometric measurements for predicting difficult laryngoscopic view in adult patients scheduled for tracheal intubation.
This single-center, prospective, observational study included 212 adult patients with American Society of Anesthesiologists physical status I-III who were scheduled for elective surgery under general anesthesia requiring tracheal intubation.
modest accuracy, correctly ranks difficult vs easy views about two-thirds of the time
Difficult laryngoscopic view was identified in 44 of 212 patients (20.8%).
Patients with difficult laryngoscopic view had significantly higher body weight and body mass index, smaller mouth opening, and greater hyoid-skin distance.
In multivariable logistic regression analysis, body mass index and hyoid-skin distance were independently associated with difficult laryngoscopic view, whereas greater mouth opening had a protective effect.
Focused upper airway ultrasonography may provide complementary objective information when used together with conventional preoperative airway assessment.
Hyoid-skin distance was independently associated with difficult laryngoscopic view and demonstrated relatively high specificity; however, its discriminatory performance was modest and its sensitivity was limited.
Therefore, hyoid-skin distance and the combined model should not be interpreted as standalone screening tools for excluding difficult laryngoscopic view.