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Ultrasound guided measurement of anterior neck tissue for the prediction of difficult airway: A prospective observational study

Reema Kaul
Reema Kaul
, 
Dipali Singh
Dipali Singh
, 
Jay Prakash
Jay Prakash
, 
Shio Priye
Shio Priye
, 
Sourabh Kumar
Sourabh Kumar
 und 
Bharati
Bharati
   | 29. Dez. 2022
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Article Category: Original Paper
Online veröffentlicht: 29. Dez. 2022
Seitenbereich: 105 - 110
DOI: https://doi.org/10.2478/rjaic-2021-0018
Schlüsselwörter
© 2021 Reema Kaul et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Relationship between airway parameters and screening parameters.

  DSEM (cm) DSHB (cm) DSAC (cm) MMS TMD (cm) IIG (cm) NC (cm) SD (cm)
  r-value P-value r-value P-value r-value P-value r-value P-value r-value P-value r-value P-value r-value P-value r-value P-value
DSEM (cm) - - .559 <0.001 .784 <0.001 .437 <0.001 -.324 .001 .007 .943 .399 <0.001 -.167 .097
DSHB (cm) .559 <0.001 - - .532 <0.001 .550 <0.001 -.365 <0.001 -.016 .875 .429 <0.001 -.246 .014
DSAC (cm) .784 <0.001 .532 <0.001 - - .530 <0.001 -.408 <0.001 .118 .242 .334 .001 -.310 .002
MMS .437 <0.001 .550 <0.001 .530 <0.001 - - -.256 .010 .051 .615 .335 .001 -.284 .004
TMD (cm) -.324 .001 -.365 <0.001 -.408 <0.001 -.256 .010 - - .349 <0.001 .065 .519 .419 <0.001
IIG (cm) .007 .943 -.016 .875 .118 .242 .051 .615 .349 <0.001 - - .166 .100 .122 .228
NC (cm) .399 <0.001 .429 <0.001 .334 .001 .335 .001 .065 .519 .166 .100 - - -.228 .022
SD (cm) -.167 .097 -.246 .014 -.310 .002 -.284 .004 .419 <0.001 .122 .228 -.228 .022 - -

Airway evaluating parameters for predicting difficult laryngoscopy.

Variable Difficult (n=39) Easy (n=61) P-value
MMS     <0.001
MMS 1 6 (15.4%) 24 (39.3%)  
MMS 2 5 (12.8%) 31 (50.8%)  
MMS 3 25 (64.1%) 6 (9.8%)  
MMS 4 3 (7.7%) 0 (0.0%)  
ULBT     <0.001
ULBT 1 29 (74.4%) 61 (100%)  
ULBT 2 10 (25.6%) 0 (0%)  
TMD 6.61 ± 1.02 7.62 ± 1.26 <0.001
IIG 6.29 ± 0.85 6.34 ± 0.57 0.76
SD 16.34 ± 2.41 17.60 ± 1.57 0.002
NC 35.18 ± 3.14 33.13 ± 2.64 0.001
DSHB 1.03 ± 0.20 0.82 ± 0.13 <0.001
DSEM 1.49 ± 0.11 1.14 ± 0.14 <0.001
DSAC 1.92 ± 0.15 1.43 ± 0.10 <0.001

Demographic data of the patients with difficult and easy laryngoscopy.

Variable Difficult (n = 39) Easy (n = 61) P-value
Age 41.05 ± 12.97 38.20 ± 10.76 0.24
Sex (M/F) 13(33.3%)/26(66.6%) 29(47.5%)/32(52.5%) 0.21
ASA (I/II) 29(74.4%)/10(25.6%) 42(68.9%)/19(31.1%) 0.61
Height 157.97 ± 5.25 157.48 ± 5.63 0.66
Weight 63.87 ± 11.61 56.89 ± 9.01 0.01
BMI 25.59 ± 4.10 22.89 ± 3.21 <0.01

The area under the ROC curves (AUC) for DSEM, DSHB, DSAC, TMD, and MMS.

Variable AUC ± SE P-value 95% CI
DSHB 0.799 ± 0.052 <0.001 0.698 to 0.901
DSEM 0.975 ± 0.012 <0.001 0.951 to 1.0
DSAC 0.999 ± 0.001 <0.001 0.997 to 1.0
TMD 0.725 ± 0.054 <0.001 0.619 to 0.830
MMS 0.800 ± 0.051 <0.001 0.700 to 0.899

Table Optimal cut-off values with sensitivity and specificity to predict difficult laryngoscopy.

Variable Cut-off values Sensitivity Specificity
DSEM 1.34 93% 82%
DSHB 0.98 92% 69%
DSAC 1.68 100% 95%
TMD 6.59 87% 54%
MMS 2 90% 72%
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