Since the introduction of real-time ultrasound (US) capabilities, ultrasound technology has been adopted and incorporated into daily practice by many medical and surgical specialties. Using US to help assess the difficult airway constitutes just yet another valuable application of this versatile technology . Since many anesthesia providers had already acquired proficiency in US techniques in US guided vascular access and regional nerve blocks, using US to evaluate the airway could be learned and mastered without too much difficulty. Ultrasound of the upper airway may prove to become a useful adjunct to conventional clinical assessment tools, as it has been successful in visualizing the relevant anatomy and critical structures of the airway..
The study is cross sectional observational study in which obese patients will be assessed using conventional clinical methods of airway assessment and by using US for the same patient before induction of anesthesia then correlated to the Cormack-Lehane finding after induction of anesthesia..
Study Type
OBSERVATIONAL
Enrollment
78
Assessing validity of ultrasound as regards correlation to Cormack-Lehane grading in obese patients
Zagazig University
Zagazig, Egypt
RECRUITINGThe ratio of the depth of the pre-epiglottic space (Pre-E) to the distance from the epiglottis to the mid-point of the distance between the vocal cords (E-VC).
If It is \[0-1\] ,this suspects Cormack-Lehane Grade 1.If it is \[1-2\],this suspects Cormack-Lehane Grade 2.If it is \[2-3\],this suspects Cormack-Lehane Grade 3
Time frame: through study completion, an average of 1 year
The anterior neck soft tissue thickness at the level of the vocal cords (ANS-VC)
ANS-VC \>0.23 cm had a sensitivity of 85.7% in predicting a Cormack-Lehan Grade 3 or 4
Time frame: through study completion, an average of 1 year
The anterior neck soft tissue thickness at the level of the hyoid bone (ANS-Hyoid)
If it is 1.69 cm \[1.19 cm to 2.19 cm\],this suspects difficult laryngoscopy.If it is 1.37cm \[1.27 cm to 1.46 cm\], this suspects easy laryngoscopy
Time frame: through study completion, an average of 1 year
The hyomental distance of the patient in neutral position of the neck and in fully extended neck calculating the ratio between both of them
If The mean hyomental distance ratios is (1.02 ± 0.01) ,this suspects difficult intubation.If it is (1.14 ± 0.02) ,this suspects easy intubation
Time frame: through study completion, an average of 1 year
Tongue volume will be derived from multiplication of the midsagittal cross-sectional area of the tongue by its width obtained from transverse sonograms
Large tongue volume suspects difficult laryngoscopy
Time frame: through study completion, an average of 1 year
Modified Mallampati classification
Class I is visualization of the hard palate, soft palate, fauces, uvula, and pillars. Class II is visualization of the hard palate, soft palate, fauces, and base of uvula. Class III is visualization of the hard palate and soft palate. Class IV is visualization of only the hard palate
Time frame: through study completion, an average of 1 year
Interincisor gap
If it is less than 5 cm (approximately three finger breadths) with limited forward protrusion of the mandible ,this is associated with increased risk of difficult laryngoscopy
Time frame: through study completion, an average of 1 year
Thyromental distance
If \< 6cm ,this predicts difficult laryngoscopy
Time frame: through study completion, an average of 1 year
Sternomental distance
If \< 12.5 cm ,this predicts difficult laryngoscopy
Time frame: through study completion, an average of 1 year
Neck Extension and Flexion
inability to extend or flex the neck suspects difficult laryngoscopy
Time frame: through study completion, an average of 1 year
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.