The Role of Indirect Laryngoscopy, Clinical and Ultrasonographic Assessment in Prediction of Difficult Airway
| Autor: | Levent Aydemir, Mehmet İlke Büget, Hakan Kara, Emre Camci, Said Sönmez, Demet Altun, Achmet Ali, Erol Bozbora, Mehmet Tugrul, Tugce Dinc, Bora Başaran |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Neck circumference medicine.medical_specialty Adolescent Respiratory System Urology Physical examination Sternomental distance 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Intubation Intratracheal medicine Humans Prospective Studies Airway Management Difficult airway Aged Ultrasonography Laryngoscopy medicine.diagnostic_test business.industry 030208 emergency & critical care medicine Middle Aged Thyromental distance Otorhinolaryngology Female Indirect laryngoscopy business Airway Body mass index |
| Zdroj: | The Laryngoscope. 131 |
| ISSN: | 1531-4995 0023-852X |
| DOI: | 10.1002/lary.28849 |
| Popis: | Objectives Pre-operative airway evaluation is essential to decrease the proportion of possible mortality and morbidity due to difficult airway (DA). The study aimed to evaluate the accuracy of pre-operative ultrasonographic airway assessment (UAA) and indirect laryngoscopy (IL) in predicting DA. Study design Prospective obsevational study. Methods Preoperative clinical examination (body mass index [BMI], mallampati classification [MP], thyromental distance, sternomental distance, neck circumference), UAA (epiglottis-skin distance [ESD], hyoid bone-skin distance [HSD], the thickness of tongue root [ToTR], anterior commissure-skin distance [ACSD]) and IL with the rigid 70-degree laryngoscope were performed to predict DA (Cormack-Lehane grade 3 and 4). The sensitivity, specificity, positive predictive value (PP), and negative predictive values of the parameters were assessed. Results Twenty-two of 140 (15.7%) patients were diagnosed with DA. The cut-off points of ESD, HSD, ToTR, ACSD, and BMI were 2.09 cm, 0.835 cm, 4.05 cm, 0.545 cm, and 27.10, respectively. AUC values were 0.874, 0.885, 0.871, 0.658, and 0.751 in the same order. AUC values for IL and MP were 0.773 and 0.925, respectively. MP and HSD had the best sensitivity (91%), IL grading had the best specificity (100%), and PP (100%) value among all measurements. The best-balanced sensitivity (91%), specificity (97%), and PP (88%) values were obtained by combining the IL with MP and ESD or with MP and HSD. Conclusions Ultrasonographic measurements and IL were found significantly correlated to predict DA. Combined parameters, the IL with MP and ESD or with MP and HSD, are the best parameters in predicting the DA. Level of evidence 4 Laryngoscope, 131:E555-E560, 2021. |
| Databáze: | OpenAIRE |
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