Paper Title
Evaluating Ultrasound as a Predictor for Difficult Laryngoscopy: A Prospective Study
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Registration ID: IJNRD_302406
Published ID: IJNRD2411309
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Keywords
ultrasound, Mallampati classfication, thyrohyoid membrane, difficult airway prediction, Airway assessment, Cormack- Lehane classification.
Abstract
Background: A pre-anesthetic airway assessment is mandatory before every anesthetic procedure. Unanticipated difficult intubations remain a major concern for anesthesiologists due to the potentially serious consequences of failed endotracheal intubations. The definition of difficult intubation also lacks consensus but is commonly derived from endpoints of laryngoscopy such as the Cormack–Lehane Grade [CLG]. Aim: The main objective of this research was to evaluate the effectiveness of ultrasonography as a preoperative assessment method for detecting difficult airways. The study aimed to compare and correlate the ultrasound visualization of the airway with clinical airway evaluations based on the Cormack Lehane classification during direct laryngoscopy. Material and methodology: A total of 150 patients scheduled for elective surgery requiring endotracheal intubation were enrolled in the study. Those without teeth and individuals with anatomical abnormalities in the head and neck were excluded. The day before the surgery, patients were taken to the ultrasound room in the anesthesia department for a comprehensive airway evaluation, which included assessments such as Mallampatti's classification, interincisor gap, and thyromental distance. Ultrasound was utilized to assess the thickness of soft tissues in the anterior neck at the levels of hyoid bone, at the level of thyrohyoid membrane, and at the level of suprasternal notch. On the surgical day, the attending anesthesiologist administered anesthesia in accordance with the standardized protocols provided by the anesthetists who conducted the airway evaluations. The Cormack-Lehane grade was recorded. Statistical analysis was performed on the collected data. Result: In this research, ultrasound assessments of the hyoid bone, thyrohyoid membrane, and suprasternal notch were examined for their capacity to predict challenges in airway management. The thyrohyoid membrane exhibited the most substantial relationship with airway complications (Pearson correlation of 0.68, p < 0.001), whereas the hyoid bone and suprasternal notch also demonstrated notable positive associations (r = 0.45 and r = 0.56, respectively). The highest predictive accuracy, evaluated through the area under the curve (AUC), was observed for the thyrohyoid membrane (AUC = 0.89), followed by the suprasternal notch (AUC = 0.82) and the hyoid bone (AUC = 0.76). These results indicate that ultrasound measurements, particularly at the thyrohyoid membrane, are valuable indicators for difficult intubation. Conclusion: Measurements of anterior neck soft tissue thickness obtained via ultrasound at the levels of the hyoid bone, thyrohyoid membrane, and suprasternal notch serve as independent indicators of challenging laryngoscopy. We conclude that the thickness of the thyrohyoid membrane had the strongest correlation with intubation difficulty.
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How To Cite (APA)
Mukesh K. Khunt, Solanki Paresha L, & Tushar D Bhavar (November-2024). Evaluating Ultrasound as a Predictor for Difficult Laryngoscopy: A Prospective Study . INTERNATIONAL JOURNAL OF NOVEL RESEARCH AND DEVELOPMENT, 9(11), d88-d93. https://ijnrd.org/papers/IJNRD2411309.pdf
Issue
Volume 9 Issue 11, November-2024
Pages : d88-d93
Other Publication Details
Paper Reg. ID: IJNRD_302406
Published Paper Id: IJNRD2411309
Research Area: Medical Sciences
Author Type: Indian Author
Country: Ahmednagar, Maharashtra , India
Published Paper PDF: https://ijnrd.org/papers/IJNRD2411309.pdf
Published Paper URL: https://ijnrd.org/viewpaperforall?paper=IJNRD2411309
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