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

被引:3
作者
Kim, Hye Jin [1 ]
Min, Nar Hyun [1 ]
Lee, Jong Seok [1 ]
Lee, Wootaek [1 ]
Kim, Do-Hyeong [1 ]
机构
[1] Yonsei Univ, Anesthesia & Pain Res Inst, Dept Anesthesiol & Pain Med, Coll Med, 50-1 Yonsei Ro, Seoul 03722, South Korea
关键词
ULTRASOUND; INTUBATION; CIRCUMFERENCE; MANAGEMENT; DISTANCE; ERROR; RATIO;
D O I
10.1038/s41598-021-88076-z
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
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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页数:8
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