The Effect of Thyromental Height and Other Difficult Airway Evaluation Parameters

The Effect of Thyromental Height and Other Difficult Airway Evaluation Parameters on Laryngeal Mask Placement Success Rate in Elderly Patients

Many changes occur in the body with age. There are difficulties in endotracheal intubation and the placement of supraglottic airway devices (LMA) in elderly patients due to changes in the tooth and facial structure, and a decrease in temporomandibular joint and neck movements. In the literature, there are studies on the relationship between thyromental height measurement and endotracheal intubation difficulty, but there is no study on the relationship between thyromental height measurement and laryngeal mask placement difficulty.

Age, gender, height, body weight, body mass index, type of operation, and Mallampati score are recorded in the preoperative evaluations of all patients. For anthropometric measurements, thyromental height, thyromental distance, sterno-mental distance, neck circumference, and mouth opening are measured. After the laryngeal mask is placed after the induction of anesthesia, the location of the LMA is checked with the FOB (fiberoptic bronchoscopy). Ease of insertion was subjectively assessed using a grading score of 1-4 (1, no resistance; 2, mild resistance; 3, moderate resistance; 4, inability to insert the device) by the attending anesthesiologist who inserted the device. After successful placement of the device, the adjustable pressure limiting (APL) valve is adjusted to 30 cm H2O at 3L/minute fresh gas flow, and the airway pressure and leakage amount are measured.

Inclusion Criteria:

• over 65 years old
• elective operation
• using laryngeal mask device

Exclusion Criteria:

• younger than 65 years old
• urgent or emergency operation
• morbidity obese
• contraindications of all laryngeal mask devices using