This prospective observational study aims to evaluate whether upper airway ultrasound measurements can improve the prediction of difficult airway compared with conventional anthropometric assessments. Adult patients undergoing elective procedures requiring airway management will be included. Ultrasound parameters such as tongue thickness, anterior neck soft tissue thickness, and hyomental distance will be measured before airway intervention. Standard clinical predictors (Mallampati score, thyromental distance, neck circumference, etc.) will also be recorded. The primary objective is to determine the diagnostic accuracy of ultrasound-based measurements in predicting difficult laryngoscopy and intubation. The study seeks to provide evidence supporting the integration of upper airway ultrasound into routine pre-anesthetic airway evaluation.

Inclusion Criteria:

• Adults aged 18-99 years
• Patients scheduled for elective surgery under general anesthesia
• ASA Physical Status I-III
• Able to provide informed consent
• Undergoing preoperative airway evaluation

Exclusion Criteria:

• - Emergency surgery cases
• Age <18 years
• ASA Physical Status IV-V
• Pregnant or breastfeeding patients
• Patients with limited cooperation or inability to provide consent
• Known anatomical airway anomalies or previous major neck surgery

The study population consists of adult patients (18-99 years) scheduled for elective surgery under general anesthesia at a tertiary care hospital. Participants represent typical surgical patients requiring preoperative airway assessment. No healthy volunteers will be enrolled. Only ASA I-III patients who can provide informed consent will be included.