Publication:

Use of ultrasonography as a novel tool of airway assessment in patients undergoing general anesthesia and surgery and its comparison with Cormack-Lehane classification: a prospective observational study

Background Accurate preoperative prediction of difficult airway remains a challenge in anesthetic practice. Conventional bedside airway assessment tests have limited sensitivity and specificity. Ultrasonography has emerged as a non-invasive, bedside tool for airway evaluation. This study aimed to assess the role of ultrasonography in predicting difficult laryngoscopy and to compare ultrasonographic airway parameters with the Cormack-Lehane (CL) classification obtained during direct laryngoscopy.

Methods This prospective observational study was conducted in adult patients undergoing elective surgery under general anesthesia. Preoperative airway assessment included ultrasonographic measurement of airway parameters. After induction of anesthesia, direct laryngoscopy was performed and the laryngeal view was graded according to the CL classification. The correlation between ultrasonographic findings and laryngoscopic grades was analyzed to evaluate the predictive value of ultrasound in identifying difficult laryngoscopy.

Results Ultrasonographic airway measurements demonstrated a significant correlation with laryngoscopic grading. Patients with increased ultrasonographic airway parameters were more likely to have higher CL grades (Grade III-IV), indicating difficult laryngoscopy. Ultrasonography showed good sensitivity and specificity in predicting difficult airway when compared with conventional airway assessment methods.

Conclusions Preoperative airway ultrasonography is a simple, non-invasive, and reliable tool for predicting difficult laryngoscopy. It can serve as a valuable adjunct to conventional clinical airway assessment and may improve perioperative airway management strategies.