The use of ultrasonography in predicting difficult airway

During general anesthesia, endotracheal intubation is the most crucial procedure for airway safety. The unexpected difficult airway is a major concern for anesthesiologists as it can lead to morbidity and mortality. Today, the rate of difficult laryngoscopy and difficult intubation is observed to be approximately 1.5-13%, and the rate of difficult mask ventilation is around 1.4%. Ultrasonography is a promising tool for airway assessment due to its safety, speed, repeatability, portability, and real-time dynamic imaging. In our study, we aimed to determine whether ultrasonographic measurements, used alone or in combination with routine screening tests, are significant in predicting difficult airways. After obtaining ethical approval, 66 adult patients aged 18 and older with ASA physical status I-IV, scheduled for elective surgery under general anesthesia, were included in the study. After routine airway examination, ultrasonographic measurements of epiglottis-skin distance, hyoid bone-skin distance, neutral position hyomental distance, and tongue base thickness were performed. After airway screening tests and ultrasonographic measurements, mask ventilation and endotracheal intubation were performed, and Cormack-Lehane Score and Mask Ventilation Score were recorded. Among the ultrasonographic measurements, epiglottis-skin distance, hyoid bone-skin distance, and tongue base thickness are statistically significant in predicting difficult airways. A statistically significant correlation was found between routine screening tests and ultrasonographic measurements. In conclusion, routine screening tests are insufficient in predicting difficult airways. Ultrasonographic measurements are useful in predicting difficult airways. The combination of routine screening tests and ultrasonographic measurements enhances the reliability of these tests. Keywords: difficult airway, ultrasonography, difficult laryngoscopy, difficult mask ventilation.