Evaluation of Ultrasound Guided Measurement of Anterior Neck Soft Tissue Thickness in Predicting Difficult Laryngoscopy in Obese Patients

Background: The incidence of unanticipated difficult airway is 14.3-17.5% in obese. Preoperative difficult airway prediction is important to avoid postoperative morbidity and mortality. USG guided measurement of anterior neck soft tissue thickness can be used to predict difficult laryngoscopy in ob...

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Autores principales:	Saumya Jain, Nisha kachru, Rupesh Yadav
Formato:	article
Lenguaje:	EN
Publicado:	Tehran University of Medical Sciences 2021
Materias:	Airway Body mass index Laryngoscopy Morbidity Obesity Ultrasonography Anesthesiology RD78.3-87.3 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/2f574bac5fe4488cbd16df91c4be7811
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spelling	oai:doaj.org-article:2f574bac5fe4488cbd16df91c4be78112021-11-20T04:39:32ZEvaluation of Ultrasound Guided Measurement of Anterior Neck Soft Tissue Thickness in Predicting Difficult Laryngoscopy in Obese Patients10.18502/aacc.v7i4.76272423-5849https://doaj.org/article/2f574bac5fe4488cbd16df91c4be78112021-10-01T00:00:00Zhttps://aacc.tums.ac.ir/index.php/aacc/article/view/365https://doaj.org/toc/2423-5849 Background: The incidence of unanticipated difficult airway is 14.3-17.5% in obese. Preoperative difficult airway prediction is important to avoid postoperative morbidity and mortality. USG guided measurement of anterior neck soft tissue thickness can be used to predict difficult laryngoscopy in obese patients and we thus undertook this study to determine the role of USG guided measurement of anterior neck thickness at the level of vocal cords in difficult laryngoscopy prediction. Methods: Sixty obese patients (BMI≥30kg/m2), 18-70 years of age of either sex, were included. Anterior neck soft tissue thickness was measured by ultrasound as the distance from the skin to the anterior commissure of vocal cord. Neck circumference was measured at mid neck just below the laryngeal prominence with the subjects standing upright and facing forward with shoulders relaxed. Thyromental distance, sternomental distance, Mallampatti score and neck circumference were also recorded. Results: The cut off values of BMI (46.94 kg/m2), neck circumference (41.5 cm) and anterior neck soft tissue thickness (22.1mm). Four patients in the morbidly obese and 80% of the superobese patients had a difficult laryngoscopy. Sixteen (26.67%) patients had an anterior neck soft tissue thickness of >22.1mm. Of these, 11 (91.67%) patients had difficult laryngoscopy while one (8.33%) patient with anterior neck soft tissue thickness ≤ 22.1mm had difficult laryngoscopy (P<0.05). There was also significant association between neck circumference and BMI. Conclusion: The USG guided measurement of anterior neck soft tissue thickness, BMI and neck circumference can reliably predict difficult laryngoscopy in obese patients. Saumya JainNisha kachruRupesh YadavTehran University of Medical SciencesarticleAirwayBody mass indexLaryngoscopyMorbidityObesityUltrasonographyAnesthesiologyRD78.3-87.3Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENArchives of Anesthesia and Critical Care, Vol 7, Iss 4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Airway Body mass index Laryngoscopy Morbidity Obesity Ultrasonography Anesthesiology RD78.3-87.3 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Airway Body mass index Laryngoscopy Morbidity Obesity Ultrasonography Anesthesiology RD78.3-87.3 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Saumya Jain Nisha kachru Rupesh Yadav Evaluation of Ultrasound Guided Measurement of Anterior Neck Soft Tissue Thickness in Predicting Difficult Laryngoscopy in Obese Patients
description	Background: The incidence of unanticipated difficult airway is 14.3-17.5% in obese. Preoperative difficult airway prediction is important to avoid postoperative morbidity and mortality. USG guided measurement of anterior neck soft tissue thickness can be used to predict difficult laryngoscopy in obese patients and we thus undertook this study to determine the role of USG guided measurement of anterior neck thickness at the level of vocal cords in difficult laryngoscopy prediction. Methods: Sixty obese patients (BMI≥30kg/m2), 18-70 years of age of either sex, were included. Anterior neck soft tissue thickness was measured by ultrasound as the distance from the skin to the anterior commissure of vocal cord. Neck circumference was measured at mid neck just below the laryngeal prominence with the subjects standing upright and facing forward with shoulders relaxed. Thyromental distance, sternomental distance, Mallampatti score and neck circumference were also recorded. Results: The cut off values of BMI (46.94 kg/m2), neck circumference (41.5 cm) and anterior neck soft tissue thickness (22.1mm). Four patients in the morbidly obese and 80% of the superobese patients had a difficult laryngoscopy. Sixteen (26.67%) patients had an anterior neck soft tissue thickness of >22.1mm. Of these, 11 (91.67%) patients had difficult laryngoscopy while one (8.33%) patient with anterior neck soft tissue thickness ≤ 22.1mm had difficult laryngoscopy (P<0.05). There was also significant association between neck circumference and BMI. Conclusion: The USG guided measurement of anterior neck soft tissue thickness, BMI and neck circumference can reliably predict difficult laryngoscopy in obese patients.
format	article
author	Saumya Jain Nisha kachru Rupesh Yadav
author_facet	Saumya Jain Nisha kachru Rupesh Yadav
author_sort	Saumya Jain
title	Evaluation of Ultrasound Guided Measurement of Anterior Neck Soft Tissue Thickness in Predicting Difficult Laryngoscopy in Obese Patients
title_short	Evaluation of Ultrasound Guided Measurement of Anterior Neck Soft Tissue Thickness in Predicting Difficult Laryngoscopy in Obese Patients
title_full	Evaluation of Ultrasound Guided Measurement of Anterior Neck Soft Tissue Thickness in Predicting Difficult Laryngoscopy in Obese Patients
title_fullStr	Evaluation of Ultrasound Guided Measurement of Anterior Neck Soft Tissue Thickness in Predicting Difficult Laryngoscopy in Obese Patients
title_full_unstemmed	Evaluation of Ultrasound Guided Measurement of Anterior Neck Soft Tissue Thickness in Predicting Difficult Laryngoscopy in Obese Patients
title_sort	evaluation of ultrasound guided measurement of anterior neck soft tissue thickness in predicting difficult laryngoscopy in obese patients
publisher	Tehran University of Medical Sciences
publishDate	2021
url	https://doaj.org/article/2f574bac5fe4488cbd16df91c4be7811
work_keys_str_mv	AT saumyajain evaluationofultrasoundguidedmeasurementofanteriornecksofttissuethicknessinpredictingdifficultlaryngoscopyinobesepatients AT nishakachru evaluationofultrasoundguidedmeasurementofanteriornecksofttissuethicknessinpredictingdifficultlaryngoscopyinobesepatients AT rupeshyadav evaluationofultrasoundguidedmeasurementofanteriornecksofttissuethicknessinpredictingdifficultlaryngoscopyinobesepatients
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Evaluation of Ultrasound Guided Measurement of Anterior Neck Soft Tissue Thickness in Predicting Difficult Laryngoscopy in Obese Patients

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