Petrisor Cristina, Dîrzu Dan, Trancă Sebastian, Hagău Natalia, Bodolea Constantin
Anestehsia and Intensive Care 1 Department, Clinical Emergency County Hospital Cluj-Napoca, Romania Anesthsia and Intensive care II Department, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Romania.
Clinical Emergency County Hospital Cluj-Napoca.
Med Ultrason. 2019 Feb 17;21(1):83-88. doi: 10.11152/mu-1764.
Airway management is one of the most important skills in everyday practice of anesthesia. Improper airway management might contribute to significant morbidity and mortality. In some patients, clinical parameters do not anticipate all difficulties related to airway management. Ultrasonography (US) might confer a potential screening tool for difficult airway. Suprahyoid and infrahyoid US measurements have been investigated for difficult airway prediction in anesthesiology. The most extensively investigated parameter was the anterior neck soft tissue thickness measured at different levels: anterior to the hyoid bone, epiglottis and vocal cords commissure. Hyomental distances measured with the head placed in neutral, sniffing or maximal hyperextended position and the derived hyomental distance ratios have also been evaluated for difficult airway prediction. For the evaluation of the tongue, measurements such as thickness, cross-sectional area, width, volume and tongue-to-oral cavityratio can be used. Thus, anesthesiologists have many available potential US measurements, which could provide information regarding airway anatomy during the preoperative airway assessment and could serve as potential screening parameters for difficult airway. Still, we do not yet know which of these provides optimal predictive accuracy and larger sample size studiesare required to validate their use in the preoperative evaluation of the airway.
气道管理是麻醉日常实践中最重要的技能之一。不当的气道管理可能会导致严重的发病率和死亡率。在一些患者中，临床参数无法预测与气道管理相关的所有困难。超声检查（US）可能是一种用于预测困难气道的潜在筛查工具。在麻醉学中，已对舌骨上和舌骨下超声测量用于预测困难气道进行了研究。研究最广泛的参数是在不同水平测量的颈前软组织厚度：舌骨前方、会厌和声带连合处。还评估了在头部处于中立、嗅闻或最大伸展位时测量的颌下距离以及由此得出的颌下距离比值，以预测困难气道。对于舌头的评估，可以使用厚度、横截面积、宽度、体积和舌与口腔比值等测量方法。因此，麻醉医生有许多可用的潜在超声测量方法，这些方法可以在术前气道评估期间提供有关气道解剖结构的信息，并可作为困难气道的潜在筛查参数。然而，我们尚不知道其中哪一种能提供最佳预测准确性，并需要更大样本量的研究来验证它们在术前气道评估中的应用。
