Kasinath M Pranav Rohit, Rastogi Amit, Priya Vansh, Singh Tapas Kumar, Mishra Prabhaker, Pant K C
Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Biostatistics and Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Anesth Essays Res. 2021 Jan-Mar;15(1):51-56. doi: 10.4103/aer.aer_75_21. Epub 2021 Aug 30.
Ultrasound is evolving as a probable tool in airway assessment. The upper airway is a superficial structure and has sonographically identifiable structures which makes it ideal for evaluation with the ultrasound.
The aim of this study was to evaluate the role of skin to hyoid and skin to thyrohyoid membrane distance in prediction of difficult laryngoscopy.
This is a prospective observational study included 150 patients aged 18-60 years of American Society of Anesthesiologists Physical Status I and II scheduled to undergo surgery under general anesthesia requiring laryngoscopy and endotracheal intubation.
The modified Mallampati score, mouth opening, mentohyoid distance, thyromental distance were noted. Skin to hyoid bone distance and skin to thyrohyoid membrane distance were measured by ultrasound. Patients were clubbed retrospectively into easy and difficult laryngoscopy groups on the basis of Cormack Lehane grading, and the characteristics of both groups were compared.
Statistical Package for the Social Sciences, Version 23 was used for statistical analysis. Independent samples -test was used to compare the means between difficult and easy laryngoscopy patients. Diagnostic accuracy of the significant ( < 0.05) variables between difficult and easy laryngoscopy patients was calculated using receiver operating characteristics curve in terms of their area under curve. Appropriate cutoff values (with corresponding sensitivity, specificity, and overall accuracy) were also identified.
Out of 150 patients, 13 (8.7%) were identified as difficult laryngoscopy whereas 137 patients (91.3%) were identified as easy laryngoscopy. The demographics of both groups were comparable. Mentohyoid distance, skin to hyoid bone distance, and skin to thyrohyoid distance were statistically different between easy and difficult laryngoscopy patients, with lower mentohyoid distance and higher skin to hyoid bone distance and skin to thyrohyoid distance in difficult laryngoscopy patients. Diagnostic accuracy of the mentohyoid distance (70.3%) was slightly superior to skin to hyoid bone distance (67.1%) and skin to thyrohyoid distance (68.1%).
Ultrasound measurements of skin to hyoid bone and skin to thyrohyoid membrane distance fail to eclipse clinical parameters in accurately predicting a difficult laryngoscopy.
超声正逐渐成为气道评估中一种可能的工具。上气道是一个浅表结构，具有超声可识别的结构，这使其成为超声评估的理想对象。
本研究旨在评估皮肤至舌骨距离和皮肤至甲状舌骨膜距离在预测困难喉镜检查中的作用。
这是一项前瞻性观察性研究，纳入了150例年龄在18 - 60岁之间、美国麻醉医师协会身体状况分级为I级和II级、计划在全身麻醉下接受需要喉镜检查和气管插管手术的患者。
记录改良Mallampati评分、张口度、颏舌骨距离、甲状颏距离。用超声测量皮肤至舌骨的距离和皮肤至甲状舌骨膜的距离。根据Cormack Lehane分级，将患者回顾性分为容易喉镜检查组和困难喉镜检查组，并比较两组的特征。
使用社会科学统计软件包第23版进行统计分析。采用独立样本t检验比较困难喉镜检查患者和容易喉镜检查患者的均值。使用受试者操作特征曲线根据曲线下面积计算困难喉镜检查患者和容易喉镜检查患者之间显著（P < 0.05）变量的诊断准确性。还确定了合适的截断值（以及相应的敏感性、特异性和总体准确性）。
150例患者中，13例（8.7%）被确定为困难喉镜检查，而137例患者（91.3%）被确定为容易喉镜检查。两组的人口统计学特征具有可比性。容易喉镜检查患者和困难喉镜检查患者之间的颏舌骨距离、皮肤至舌骨距离和皮肤至甲状舌骨距离在统计学上存在差异，困难喉镜检查患者的颏舌骨距离较低，皮肤至舌骨距离和皮肤至甲状舌骨距离较高。颏舌骨距离的诊断准确性（70.3%）略优于皮肤至舌骨距离（67.1%）和皮肤至甲状舌骨距离（68.1%）。
超声测量皮肤至舌骨和皮肤至甲状舌骨膜的距离在准确预测困难喉镜检查方面未能超越临床参数。
