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Anterior neck soft tissue measurements on computed tomography to predict difficult laryngoscopy: a retrospective study

 Hye Jin Kim  ;  Nar Hyun Min  ;  Jong Seok Lee  ;  Wootaek Lee  ;  Do-Hyeong Kim 
 SCIENTIFIC REPORTS, Vol.11(1) : 8438, 2021-04 
Journal Title
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Predicting difficult laryngoscopy is an essential component of the airway management. We aimed to evaluate the use of anterior neck soft tissue measurements on computed tomography for predicting difficult laryngoscopy and to present a clear measurement protocol. In this retrospective study, 281 adult patients whose tracheas were intubated using a direct laryngoscope for thyroidectomy were enrolled. On computed tomography, the distances from the midpoint of the thyrohyoid membrane to the closest concave point of the vallecular (membrane-to-vallecula distance; dMV), and to the most distant point of the epiglottis (membrane-to-epiglottis distance; dME) were measured, respectively. The extended distances straight to the skin anterior from the dMV and dME were called the skin-to-vallecula distance (dSV) and skin-to-epiglottis distance (dSE), respectively. Difficult laryngoscopy was defined by a Cormack-Lehane grade of > 2. Difficult laryngoscopy occurred in 40 (14%) cases. Among four indices, the dMV showed the highest prediction ability for difficult laryngoscopy with an area under the receiver operating characteristic curve of 0.884 (95% confidence interval 0.841-0.919, P < 0.001). The optimal dMV cut-off value for predicting difficult laryngoscopy was 2.33 cm (sensitivity 75.0%; specificity 93.8%). The current study provides novel evidence that increased dMV is a potential predictive indicator of difficult laryngoscopy.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Hyeong(김도형) ORCID logo https://orcid.org/0000-0003-2018-8090
Kim, Hye Jin(김혜진) ORCID logo https://orcid.org/0000-0003-3452-477X
Min, Nar Hyun(민나현) ORCID logo https://orcid.org/0000-0003-2367-3489
Lee, Jong Seok(이종석) ORCID logo https://orcid.org/0000-0002-7945-2530
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