Department of Anaesthesiology and Critical Care, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
Ann Afr Med. 2024 Apr 1;23(2):182-188. doi: 10.4103/aam.aam_33_23. Epub 2024 May 1.
Ultrasonographic imaging has been recently become simple portable and non-invasive adjuvant for bedside assessment of anterior neck soft tissue thickness which when measured at different levels showed to have significant role in predicting difficult laryngoscopy.
Primary objective was Ultrasonographic measurement of anterior neck soft tissue thickness at 3 levels -Distance from skin to hyoid bone (DSHB) -Distance from skin to thyrohyoid membrane (DSTM) -Distance from skin to anterior commissure of vocal cord(DSAC) and to compare and correlate the findings with Cooks modification of Cormack-Lehane score in predicting difficult laryngoscopy. Secondary objective was to compare and correlate the ultrasonographic measurements with conventional airway assessment methods.
After obtaining approval from the ethical committee, 90 Patients with BMI above 25 kg /m2 was enrolled for the study. A day before the surgery a thorough Preanaesthetic evaluation and assessment of the airway is done using conventional methods. Then on the day of surgery ultrasonographic measurement of anterior neck at 3 levels was done and after inducing the patients laryngoscopy was done and Cooks modification of Cormack-Lehane score assessed.
The optimal cut off values to predict difficult laryngoscopy was 1.26, 2 and 1.2 cms for DSHB, DSTM and DSAC respectively, and among the three skin to anterior commissure of vocal cord was observed to be best USG parameter with more area under the ROC curve.
USG measurement of anterior neck soft tissue thickness can be useful in predicting difficult laryngoscopy in overweight and obese patients also it had more diagnostic accuracy than conventional methods like MMS in predicting difficult laryngoscopy.
超声成像最近已成为一种简单、便携且非侵入性的辅助手段，可用于床边评估前颈部软组织厚度，当在不同水平进行测量时，其在预测困难喉镜检查方面具有重要作用。
主要目的是测量前颈部软组织的三个水平的超声厚度 - 从皮肤到舌骨的距离（DSHB）- 从皮肤到甲状舌膜的距离（DSTM）- 从皮肤到声带前联合的距离（DSAC），并将结果与 Cooks 改良的 Cormack-Lehane 评分进行比较和关联，以预测困难喉镜检查。次要目标是将超声测量结果与常规气道评估方法进行比较和关联。
在获得伦理委员会的批准后，纳入了 90 名 BMI 超过 25kg/m2 的患者进行研究。在手术前一天，使用常规方法进行全面的术前评估和气道评估。然后在手术当天进行前颈部的超声测量，并在诱导患者进行喉镜检查后，评估 Cooks 改良的 Cormack-Lehane 评分。
预测困难喉镜检查的最佳截断值为 1.26cm、2cm 和 1.2cm 分别用于 DSHB、DSTM 和 DSAC，在这三个参数中，皮肤到声带前联合的距离被观察到是最佳的超声参数，具有更大的 ROC 曲线下面积。
超声测量前颈部软组织厚度可用于预测超重和肥胖患者的困难喉镜检查，并且在预测困难喉镜检查方面比常规方法（如 MMS）具有更高的诊断准确性。
