Clinical trial

Ultrasound vs Clinical Parameters for Difficult Airway Prediction in Obesity

Opening soon · Not applicable · 1 countries · Registry ID NCT07528677

Opening soonNot applicableObservational

What this study is about

Obesity is associated with anatomical changes in the upper airway that increase the risk of difficult laryngoscopy and difficult mask ventilation during anesthesia. Conventional airway assessment parameters such as Mallampati score, neck circumference, and STOP-BANG scale are widely used but have limited predictive accuracy in obese patients. Airway ultrasonography has emerged as a promising non-invasive tool for difficult airway prediction; however, ultrasonographic criteria have not yet been standardized. This prospective observational study aims to evaluate the utility of airway ultrasonography in predicting difficult airway in adult obese patients (BMI \>30 kg/m²) scheduled for elective surgery under general anesthesia. Ultrasonographic measurements will include the distance from skin to hyoid bone (DSHB) at the level of the hyoid bone, the anterior neck soft tissue thickness at the thyrohyoid membrane level, and the hyomental distance ratio (HMDR). These parameters will be compared with conventional airway assessment tools and correlated with intraoperative Cormack-Lehane laryngoscopy grade and Han Scale mask ventilation score to determine their predictive value for difficult airway.

A promising-looking record is not the same as confirmed eligibility. The study team must review the full criteria and current recruitment status.

Basic eligibility

Age18 Years to 65 Years

SexAll

Healthy volunteersNot accepted

ConditionObesity (BMI > 35), Difficult Airway, Difficult Airway Intubation, Difficult Mask Ventilation

Full registry criteria

Inclusion Criteria: * Age 18-65 years * BMI \>30 kg/m2 * ASA physical status I, II, or III * Scheduled for elective surgery requiring orotracheal intubation under general anesthesia * Written informed consent obtained Exclusion Criteria: * Emergency surgery * History of previous head and neck surgery or radiotherapy * Known or anticipated difficult airway (history of difficult intubation) * Presence of cervical spine pathology or limited neck mobility * Presence of oropharyngeal or laryngeal pathology * Pregnancy * Patients with tracheostomy * Refusal to participate

Treatments and study arms

Airway Ultrasonography

Diagnostic Test

Preoperative airway ultrasonography will be performed by a trained anesthesiologist using a linear ultrasound probe with the patient in the supine position and head in neutral position. The following measurements will be obtained: (1) minimum distance from skin to hyoid bone (DSHB) at the transverse view of the hyoid bone level, (2) anterior neck soft tissue thickness at the thyrohyoid membrane level, and (3) hyomental distance ratio (HMDR), calculated as the ratio of hyomental distance in full extension (HMDe) to hyomental distance in neutral position (HMDn). These ultrasonographic parameters will be correlated with intraoperative Cormack-Lehane laryngoscopy grade and Han Scale mask ventilation score to assess their predictive value for difficult airway in obese patients.

Primary outcomes

Correlation of Ultrasonographic Airway Parameters (DSHB and HMDR) with Cormack-Lehane Laryngoscopy GradePerioperative/Periprocedural

Preoperative ultrasonographic measurements including the minimum distance from skin to hyoid bone (DSHB) at the hyoid bone level and the hyomental distance ratio (HMDR, calculated as hyomental distance in full extension divided by hyomental distance in neutral position) will be correlated with the intraoperative Cormack-Lehane laryngoscopy grade. Cormack-Lehane grades III and IV will be defined as difficult laryngoscopy. The diagnostic accuracy of DSHB and HMDR in predicting difficult laryngoscopy will be assessed using ROC curve analysis.

Study locations

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Fatih Sultan Mehmet Training and Research Hospital🌐 Istanbul, Turkey (Türkiye)

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cansu ofluoglu, MDContact

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