Radiologic Indicators for Prediction of Difficult Laryngoscopy in Patients with Cervical Spondylosis

Overview

Journal Acta Anaesthesiol Scand

Specialty Anesthesiology

Date 2018 Feb 2

PMID 29388207

Citations 17

Authors

Y Z Han

Y Tian

H Zhang

Y Q Zhao

M Xu

X Y Guo

Affiliations

Soon will be listed here.

Abstract

Background: We identified the most useful variables for prediction of difficult laryngoscopy in patients with cervical spondylosis according to physical indicators and preoperative skeletal X-ray and soft tissue MRI measurements. We hypothesized that there was a closer association between difficult laryngoscopy and radiologic indicators.

Methods: We randomly enroled 315 patients undergoing elective cervical spine surgery and analysed the radiological and physical data in predicting difficult laryngoscopy.

Results: We identified five variables that were most useful in predicting difficult laryngoscopy: the inter-incisor gap (P = 0.006), modified Mallampati test score (P = 0.004), distance from the highest point of the hyoid bone to the mandibular body (P < 0.001), most antero-inferior point of the upper central incisor tooth (P < 0.001), and length of the epiglottis (P = 0.002). Binary multivariate logistic regression analyses identified three factors that were independently associated with difficult laryngoscopy: the Mallampati score, distance from the hyoid bone to the mandibular body, and the anterior-inferior point of the upper central incisor tooth. The odds ratios and 95% confidence intervals were 1.547 (1.029-2.327), 1.222 (1.139-1.310), and 1.224 (1.133-1.322), respectively. The AUC for hyoid bone distance to mandibular body (0.832) was larger than that of anterior-inferior point of the upper central incisor tooth (0.802, P > 0.05) and that of modified Mallampati test (0.602, P < 0.05).

Conclusion: Distance from the highest point of the hyoid bone to the mandibular body appears to be the most accurate indicator for difficult laryngoscopy in patients with cervical spondylosis.

Citing Articles

Radiological indicators and a novel combined predictive model for anticipating difficult laryngoscopy in cervical spondylosis patients: a prospective cohort study.

Li J, Tian Y, Wang M, Fang J, Zhang H, Yue F BMC Anesthesiol. 2024; 24(1):446.

PMID: 39623345 PMC: 11610216. DOI: 10.1186/s12871-024-02826-w.

The Future of Artificial Intelligence Using Images and Clinical Assessment for Difficult Airway Management.

De Rosa S, Bignami E, Bellini V, Battaglini D Anesth Analg. 2024; 140(2):317-325.

PMID: 38557728 PMC: 11687942. DOI: 10.1213/ANE.0000000000006969.

Trends in Preoperative Airway Assessment.

Marchis I, Negrut M, Blebea C, Crihan M, Alexa A, Breazu C Diagnostics (Basel). 2024; 14(6).

PMID: 38535030 PMC: 10968937. DOI: 10.3390/diagnostics14060610.

Identification of difficult laryngoscopy using an optimized hybrid architecture.

Liu X, Flanagan C, Li G, Lei Y, Zeng L, Fang J BMC Med Res Methodol. 2024; 24(1):4.

PMID: 38177983 PMC: 10765670. DOI: 10.1186/s12874-023-02115-z.

Preoperative radiological indicators for prediction of difficult laryngoscopy in patients with atlantoaxial dislocation.

Qu Y, Tian Y, Fang J, Tian Y, Han D, Ren L Heliyon. 2023; 10(1):e23435.

PMID: 38148803 PMC: 10750185. DOI: 10.1016/j.heliyon.2023.e23435.

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