A quantitative study of airway ultrasound in predicting difficult laryngoscopy:A prospective study  

作　　者：Lin Ning Xing Zhu Hong-Chao Li Shi-Jie Zhou Qi-Wei Zhang Hong-Yu Zou Qing-Xiang Mao Hong Yan 

机构地区：[1]Department of Anaesthesiology,Army Medical Center of PLA,Daping Hospital of Army Medical University,Chongqing,China [2]Laboratory of Anaesthesia Center,Army Medical Center of PLA,Daping Hospital of Army Medical University,Chongqing,China [3]Anaesthesia Center,Army Medical Center of PLA,Daping Hospital of Army Medical University,Chongqing,China

出　　处：《Chinese Journal of Traumatology》2023年第6期351-356,共6页中华创伤杂志（英文版）

基　　金：This research was supported by the Special Project of Technological Innovation and Application Development of Chongqing,China(Grant NO.cstc2019jscx-msxmX0248).

摘　　要：Purpose:As common clinical screening tests cannot effectively predict a difficult airway,and unanticipated difficult laryngoscopy remains a challenge for physicians.We herein used ultrasound to develop some point-of-care predictors for difficult laryngoscopy.Methods:This prospective observational study included 502 patients who underwent laryngoscopy and a detailed sonographic assessment.Patients under 18 years old,or with maxillofacial deformities or fractures,limited mouth opening,limited neck movement or history of neck surgery were excluded from the study.Laryngoscopic views of all patients were scored and grouping using the modified Cormack-Lehane(CL)scoring system.The measurements acquired comprised tongue width,the longitudinal cross-sectional area of the tongue,tongue volume,the mandible-hyoid bone distance,the hyoid boneglottis distance,the mandible-hyoid bone-glottis angle,the skin-thyrohyoid membrane distance,the glottis-superior edge of the thyroid cartilage distance(DGTC),the skin-hyoid bone distance,and the epiglottis midway-skin distance.ANOVA and Chi-square were used to compare differences between groups.Logistic regression was used to identify risk factors for difficult laryngoscopy and it was visualized by receiver operating characteristic curves and nomogram.R version 3.6.3 and SPSS version 26.0 were used for statistical analyses.Results:Difficult laryngoscopy was indicated in 49 patients(CL grade III-IV)and easy laryngoscopy in 453 patients(CL grade I-II).The ultrasound-measured mandible-hyoid bone-glottis angle and DGTC significantly differed between the 2 groups(p<0.001).Difficult laryngoscopy was predicted by an area under the curve(AUC)of 0.930 with a threshold mandible-hyoid bone-glottis angle of 125.5and by an AUC of 0.722 with a threshold DGTC of 1.22 cm.The longitudinal cross-sectional area of the tongue,tongue width,tongue volume,the mandible-hyoid distance,and the hyoid-glottis distance did not significantly differ between the groups.Conclusion:Difficult laryngoscopy may be anticipat

关 键 词：Airway management INTUBATION ULTRASONOGRAPHY AIRWAY Difficult laryngoscopy 

分 类 号：R445.1[医药卫生—影像医学与核医学] R767[医药卫生—诊断学]