Comparison of radiological measurements markers with conventional methods for prediction of difficult intubation: A prospective double-blind, observationalstudy

Difficult airway and difficult intubation are one of the most important challenges faced by anesthesiologists. Predicting difficult intubation preoperatively and making preparations accordingly are indispensable for prevention of complications and therefore patient health. In some cases, traditional subjective measurements, such as Mallampati and Cormack-Lehane which may vary according to the practitioner, cannot be sufficiently predictive and reliable due to their low sensitivity and specificity. Therefore, the search for new objective parameters and methods in predicting intubation difficulty continues. In this study, we planned to investigate the predictive values of radiological markers of difficult intubation that have just started to make their place in the literature, as well as traditional tests such as modified Mallampati, Cormack-Lehane scores, thyromental distance, sternomental distance. 70 patients who were prepared for elective surgery under general anesthesia by the Gaziantep University Faculty of Medicine, Şahinbey Research and Practice Hospital Department of Neurosurgery and Department of Anesthesiology and Reanimation, and who would routinely undergo computerized tomography and plain radiography imaging. Anthropometric measurements, thyromental distance, sternomental distance, Cormack-Lehane and Mallampati scores of the patients included in the study were recorded. Skin-vallecular distance, skin-epiglottic distance, skin-glottic distance, tongue length and height, epiglottis length and angle were also measured from preoperative imaging. As a result, while thyromental and sternomental distance and Mallampati and Cormack-Lehane scores significantly different in the difficult intubation group from easy intubation group, no significant difference was observed between the measurements of radiological indices in the difficult intubation and easy intubation groups.