Prediction of difficult laryngoscopy in obese patients by ultrasound quantification of anterior neck soft tissue*
Open Access
- 20 October 2003
- journal article
- forum
- Published by Wiley in Anaesthesia
- Vol. 58 (11), 1111-1114
- https://doi.org/10.1046/j.1365-2044.2003.03412.x
Abstract
In 50 morbidly obese patients, we quantified the soft tissue of the neck from the skin to the anterior aspect of the trachea at the vocal cords using ultrasound. Thyromental distance, mouth opening, limited neck mobility, modified Mallampati score, abnormal upper teeth, neck circumference and sleep apnoea were assessed as predictors of difficult laryngoscopy. Of the nine (18%) cases of difficult laryngoscopy, seven (78%) had a history of obstructive sleep apnoea, compared with two of the 41 patients (5%) in whom laryngoscopy was easy (p < 0.001). Patients in whom laryngoscopy was difficult had more pretracheal soft tissue (mean (SD) 28 (2.7) mm vs. 17.5 (1.8) mm; p < 0.001) and a greater neck circumference (50 (3.8) vs. 43.5 (2.2) cm; p < 0.001). None of the other predictors correlated with difficult laryngoscopy. We conclude that an abundance of pretracheal soft tissue at the level of the vocal cords is a good predictor of difficult laryngoscopy in obese patients.Keywords
This publication has 18 references indexed in Scilit:
- Increased body mass indexper se is not a predictor of difficult laryngoscopyCanadian Journal of Anesthesia/Journal canadien d'anesthésie, 2003
- Morbid Obesity and Tracheal IntubationAnesthesia & Analgesia, 2002
- The Incidence of Class “Zero” Airway and the Impact of Mallampati Score, Age, Sex, and Body Mass Index on Prediction of Laryngoscopy GradeAnesthesia & Analgesia, 2001
- The Efficacy of the "BURP" Maneuver During a Difficult LaryngoscopyAnesthesia & Analgesia, 1997
- The Efficacy of the "BURP" Maneuver During a Difficult LaryngoscopyAnesthesia & Analgesia, 1997
- Use of B-mode Ultrasound for Visceral Fat Mass Evaluation: Comparisons with Magnetic Resonance Imaging.Applied Human Science, 1995
- The airway: problems and predictions in 18,500 patientsCanadian Journal of Anesthesia/Journal canadien d'anesthésie, 1994
- Relative Risk Analysis of Factors Associated with Difficult Intubation in Obstetric AnesthesiaAnesthesiology, 1992
- Difficult tracheal intubation: a retrospective studyAnaesthesia, 1987
- Difficult tracheal intubation in obstetricsAnaesthesia, 1984