Airway Ultrasound Indices for Prediction of Difficult Laryngoscopy in Pediatric Patients

Airway Ultrasound Indices Versus Clinical Assessment for Prediction of Difficult Laryngoscopy in Elective Surgical Pediatric Patients

The goal of this observational study is to compare the airway ultrasound indices and the preoperative clinical airway assessment concerning the difficult laryngoscopic view in paediatric patients undergoing elective surgery under general anaesthesia

The main question it aims to answer is:

• Do airway ultrasound indices better predict difficult laryngoscopic view in paediatric patients than clinical airway assessment?

Airway-related morbidity, as a result of an inability to anticipate a difficult airway, remains the primary concern for an anesthesiologist. Various clinical measurements and methods, such as the thyromental distance (TMD), sternomental distance, horizontal length of the mandible, head and neck movement, and the Mallampati score, were used to predict difficult laryngoscopy and intubation in adult patients. However, using these measurements in the pediatric population is not as easy as in adults.

The use of airway sonography has been extended as an assessment tool for a difficult airway. Various parameters like tongue thickness, anterior soft tissue thickness, and hyomental distance ratio have been used to predict a difficult airway. However, the usefulness of ultrasonography to predict a difficult airway in infants and children has still not been described. This study will compare the effectiveness of clinical measurements to the ultrasound indices in predicting difficult laryngoscopic view in paediatric patients.

Inclusion Criteria:

• ASA Class I and II.
• Patients undergoing elective surgery under general anaesthesia

Exclusion Criteria:

• Congenital upper airway malformation.
• Head and neck swellings.
• Scars.
• Radiation to the neck.
• Tracheotomy.
• Neurosurgical or cardiac procedures.
• ENT surgeries.