This study aims to evaluate the diagnostic accuracy of ultrasonographic airway examination in predicting difficult laryngoscopy in pediatric patients undergoing elective surgery.

A difficult airway in a paediatric patient can be a stressful situation for anaesthesiologists as the most common causes of anaesthesia-related deaths were the result of difficult intubation, which is a more common problem in children than in adults.

Ultrasonography is a valuable, promising tool for preoperative airway evaluation through identifying important son anatomy of the upper airway, such as epiglottis, thyroid cartilage, and vocal cords.

Many studies have shown that some ultrasonic parameters can predict difficult airways in adults, such as tongue thickness, hyomental distance in the extended position (HMDE), distance from skin to epiglottis (DSE), tongue volume, midsagittal tongue cross-sectional area (TCSA), and tongue width. However, whether these parameters can be used to predict difficult laryngoscopy in children is unclear and needs extensive studies

Inclusion Criteria:

• Children aged (2-5) years old.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status I or II.
• Undergoing elective surgery under general anaesthesia with endotracheal intubation.

Exclusion Criteria:

• Maxillofacial trauma
• Large mass.
• Scar under the chin.
• History of neck surgery or congenital anomalies of the head and neck as difficult intubation is expected in these cases.

This prospective observational study will be carried out on 308 children of both genders, American Society of Anesthesiology (ASA) physical status I or II, who will be prepared for elective surgery under general anaesthesia with tracheal intubation.

The data will be available upon a reasonable request from the corresponding author after the end of study for one year.

After the end of study for one year.

The data will be available upon a reasonable request from the corresponding author.