Accuracy of ultrasonic localization of cervical anatomy in predicting difficult laryngoscopy / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the accuracy of ultrasonic localization of cervical anatomy in predicting difficult laryngoscopy.Methods:A total of 91 patients, with body mass index of 18.2-25.7 kg/m 2, aged 18-75 yr, regardless of gender, with a head and neck mobility>90°, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective surgery requiring oral tracheal intubation under general anesthesia, were included in the study.The position of cervical transverse process corresponding to vocal cords (T x), distance from combination of vocal cords to connecting wire of two anterior tubercles of transverse processes (DVA), length of genitoglossus muscle, and distance from skin to combination of vocal cords(DSV)were localized by ultrasound before anesthesia induction.Laryngoscopy was used to expose the glottis, and then endotracheal intubation was performed.Patients were divided into 2 groups according to Cormack-Lehane classification non-difficult laryngoscopy group (group N) and difficult laryngoscopy group (group L). The areas under the receiver operating characteristic curve (AUC) were used to evaluate the accuracy of T x, DVA, length of genitoglossus muscle and DSV in predicting difficult laryngoscopy. Results:The AUC of T x, DVA, length of genitoglossus muscle and DSV in predicting difficult laryngoscopy was 0.748, 0.851, 0.839 and 0.845, respectively, the sensitivity was 70.83%, 75.00%, 79.17% and 87.50%, respectively, and the specificity was 89.55%, 89.55%, 86.57% and 83.58%, respectively, and the cut-off values were T 4, 4.43 cm, 3.81 cm and 0.72 cm, respectively.There was no statistically significant difference in the AUC of T x, DVA, length of genitoglossus muscle and DSV in predicting difficult laryngoscopy ( P>0.05). Conclusion:T x, DVA, length of genitoglossus muscle and DSV localized by ultrasound all can predict difficult laryngoscopy accurately.