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Ultrasound vs Clinical Parameters for Difficult Airway Prediction in Obesity

ConditionsObesity (BMI > 35)Difficult AirwayDifficult Airway IntubationDifficult Mask Ventilation
Trial statusNot yet recruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18-65
SponsorFatih Sultan Mehmet Training and Research Hospital

About this trial

Obesity is associated with anatomical changes in the upper airway that increase the risk of difficult laryngoscopy and difficult mask ventilation during anesthesia. Conventional airway assessment parameters such as Mallampati score, neck circumference, and STOP-BANG scale are widely used but have limited predictive accuracy in obese patients. Airway ultrasonography has emerged as a promising non-invasive tool for difficult airway prediction; however, ultrasonographic criteria have not yet been standardized.

This prospective observational study aims to evaluate the utility of airway ultrasonography in predicting difficult airway in adult obese patients (BMI \>30 kg/m²) scheduled for elective surgery under general anesthesia. Ultrasonographic measurements will include the distance from skin to hyoid bone (DSHB) at the level of the hyoid bone, the anterior neck soft tissue thickness at the thyrohyoid membrane level, and the hyomental distance ratio (HMDR). These parameters will be compared with conventional airway assessment tools and correlated with intraoperative Cormack-Lehane laryngoscopy grade and Han Scale mask ventilation score to determine their predictive value for difficult airway.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age 18-65 years

BMI >30 kg/m2

ASA physical status I, II, or III

Scheduled for elective surgery requiring orotracheal intubation under general anesthesia

Disqualifiers

Emergency surgery

History of previous head and neck surgery or radiotherapy

Known or anticipated difficult airway (history of difficult intubation)

Presence of cervical spine pathology or limited neck mobility

Trial population

Adult obese patients (BMI \>30 kg/m², aged 18-65 years, ASA I-III) scheduled for elective surgery requiring orotracheal intubation under general anesthesia at Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.

Trial design

Design model

Cohort

Time perspective

Prospective

Treatments tested in this trial

  • Airway Ultrasonography

    Diagnostic test

    Preoperative airway ultrasonography will be performed by a trained anesthesiologist using a linear ultrasound probe with the patient in the supine position and head in neutral position. The following measurements will be obtained: (1) minimum distance from skin to hyoid bone (DSHB) at the transverse view of the hyoid bone level, (2) anterior neck soft tissue thickness at the thyrohyoid membrane level, and (3) hyomental distance ratio (HMDR), calculated as the ratio of hyomental distance in full extension (HMDe) to hyomental distance in neutral position (HMDn). These ultrasonographic parameters will be correlated with intraoperative Cormack-Lehane laryngoscopy grade and Han Scale mask ventilation score to assess their predictive value for difficult airway in obese patients.

Treatment groups

70 Participants
are divided into 1 treatment group
Group A: Obese Patients Undergoing General Anesthesia1 intervention

Trial outcomes

Primary outcomes

1

Correlation of Ultrasonographic Airway Parameters (DSHB and HMDR) with Cormack-Lehane Laryngoscopy Grade

Preoperative ultrasonographic measurements including the minimum distance from skin to hyoid bone (DSHB) at the hyoid bone level and the hyomental distance ratio (HMDR, calculated as hyomental distance in full extension divided by hyomental distance in neutral position) will be correlated with the intraoperative Cormack-Lehane laryngoscopy grade. Cormack-Lehane grades III and IV will be defined as difficult laryngoscopy. The diagnostic accuracy of DSHB and HMDR in predicting difficult laryngoscopy will be assessed using ROC curve analysis.

Time frame
Perioperative/Periprocedural

Secondary outcomes

1

Predictive Value of Conventional Airway Parameters for Difficult Laryngoscopy

Conventional preoperative airway assessment parameters including Mallampati score, neck circumference, and STOP-BANG scale will be correlated with intraoperative Cormack-Lehane laryngoscopy grade. Cormack-Lehane grades III and IV will be defined as difficult laryngoscopy. The diagnostic accuracy of each conventional parameter will be assessed using ROC curve analysis and compared with ultrasonographic parameters.

Time frame
Perioperative/Periprocedural
2

Predictive Value of Ultrasonographic and Conventional Airway Parameters for Difficult Mask Ventilation

Preoperative ultrasonographic measurements (DSHB and HMDR) and conventional airway parameters (Mallampati score, neck circumference, STOP-BANG scale) will be correlated with intraoperative mask ventilation difficulty graded using the Han Scale. Han Scale grades III and IV will be defined as difficult mask ventilation. Diagnostic accuracy of each parameter will be assessed using ROC curve analysis.

Time frame
Perioperative/Periprocedural

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Fatih Sultan Mehmet Training and Research Hospital

Lead sponsor

Source ClinicalTrials.gov

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