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Masters Thesis | Anaesthesiology | India | Volume 14 Issue 2, February 2025 | Popularity: 3.8 / 10

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Correlation of Preoperative Airway Assessment by Ultrasound Recorded Parameters and Conventional Physical Parameters with Cormack Lehane Grading to Predict Difficult Laryngoscopy: A Cohort Analytical Study

Dr. Manjeet Kaur Banwait, Dr. Pratibha Jain Shah, Dr. Falgudhara Panda

Abstract: Background: Conventional physical parameters have shown low Sensitivity (52.17%) and low Specificity (70%). Ultrasound based airway assessment has been proposed recently as a useful, simple, noninvasive helpful bedside technique with high Sensitivity (75%) and Specificity (97.96%) for predicting difficult airway as compared to physical parameters. Materials and Methods: This cohort analytical study involved total of 67 patients (aged 18-60 years, ASA grades I and II) requiring elective endotracheal intubation. Clinical parameters (Mallampati grading, Thyromental distance, Hyomental distance) and ultrasound parameters (distance from skin to hyoid bone, distance from skin to anterior commissure, distance from skin to thyroid isthmus, distance from skin to epiglottis midway, Ratio of pre-epiglottic depth to epiglottis vocal cord distance) were assessed preoperatively and then corelated with Cormack-Lehane grading after induction. An experienced anesthesiologist performed laryngoscopy and intubation to predict difficult laryngoscopy. Cormack-Lehane grade 3 and 4 was defined as difficult laryngoscopy. Results: Our study showed that ultrasound assessment of anterior neck soft tissues can effectively predict difficult laryngoscopy. Distance from skin to hyoid bone is the key parameter with a cut-off of 1.21 cm provides 85.79% sensitivity and 84.78% specificity for difficult laryngoscopy, with Area under curve of 0.899 indicating a strong positive correlation with Cormack-Lehane grade at cut-off value of 1.21 cm. Conclusion: This confirms the relationship between ultrasound parameters and difficult laryngoscopy. All ultrasound parameters had correlation with difficult laryngoscopy with Distance from skin to hyoid bone being most potential predictor of difficult laryngoscopy with sensitivity 85.79%, specificty 84.78%, negative predictive value 92.86%, diagnostic value 85.07% at cut-off value of 1.21cm.

Keywords: Difficult airway, Airway ultrasound, Mallampatti grading, Distance from skin to hyoid bone, Han?s scale, Cormack-Lehane grading, Difficult laryngoscopy

Edition: Volume 14 Issue 2, February 2025

Pages: 126 - 132

DOI: https://www.doi.org/10.21275/SR25129103425

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