Indirect Laryngoscopy and Ultrasonography in Prediction of Difficult Airway

Istanbul University140 enrolled

Overview

This study was designed to assess the success of indirect laryngoscopy and ultrasonographic measurements in the prediction of difficult airway. All patients were examined by indirect laryngoscopy and ultrasonography preoperatively and the predictive values for difficult airway of these methods were compared.

Difficult airway is a condition that increases the patient's vital risk and leaves the anesthesia and surgical team in a difficult position. Failure to perform an adequate preoperative evaluation may result in the team being unprepared. Therefore, various methods have been investigated in the prediction of difficult airway from past to present. With the development of technology, imaging methods have become routine applications in clinical use. Ultrasonography and indirect laryngoscopy have been shown to be used in predicting difficult airway in the literature, but there is no study showing which is a better predictor.

Study Type

OBSERVATIONAL

Enrollment

140

Conditions

Difficult Intubation

Interventions

Ultrasonographic upper airway measurementsDIAGNOSTIC_TEST

Ultrasonographic upper airway measurements: Epiglottis-skin distance, Hyoid bone-skin distance, Anterior commissure-skin distance and Thickness of tounge root. Indirect Laryngoscopy: Grading of laryngoscopic view (I=Visible anterior commissure and vocal cords, II= visible posterior part of vocal cords and posterior commissure, III= Visible posterior commissure and epiglottis, IV= Visible only epiglottis tip and posterior pharyngeal wall)

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Subject is operated in ear, nose and throat department. * Subject over the age of 18. * Subject giving consent to participate in the study. Exclusion Criteria: * Subject under the age of 18 * Subject with a history of radiotherapy in the head and neck region, * Subject with facial deformity, * Subject whose neck movements have been restricted by previous trauma or surgery, * Subject has laryngeal disease * Previously operated subject with known airway assessment * Morbidly obese subject with BMI\> 40

Locations (1)

Istanbul University, Istanbul Faculty of Medicine

Istanbul, Turkey (Türkiye)

Outcomes

Primary Outcomes

Cormack-Lehane Classification

The anesthesiologist, who is blind about indirect laryngoscopy findings and ultrasonographic airway measurements, performs intubation and evaluates the laryngeal view.

Time frame: Three minutes after induction of anesthesia.

Epiglottis skin distance in centimeters.

The anesthesiologist, who is blind about indirect laryngoscopy findings and is experienced user of ultrasonography, measures epiglottis to skin distance.

Time frame: Five minutes before induction of anesthesia.

Hyoid bone-skin distance in centimeters.

The anesthesiologist, who is blind about indirect laryngoscopy findings and is experienced user of ultrasonography, measures hyoid bone to skin distance.

Time frame: Five minutes before induction of anesthesia.

Anterior commissure-skin distance in centimeters.

The anesthesiologist, who is blind about indirect laryngoscopy findings and is experienced user of ultrasonography, measures anterior commissure to skin distance.

Time frame: Five minutes before induction of anesthesia.

Thickness of tongue root in centimeters.

The anesthesiologist, who is blind about indirect laryngoscopy findings and is experienced user of ultrasonography, measures thickness of tongue root.

Time frame: Five minutes before induction of anesthesia.

Indirect Laryngoscopic Grade

The otolaryngologist,who is blind about ultrasonographic airway measurements of patients, performs indirect laryngoscopy and evaluates the laryngeal view.

Time frame: The day before surgery

Secondary Outcomes

Data from ClinicalTrials.gov

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