Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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To Study the Ultrasound Based Assessment of Hyomental Distance in Different Position and Its Derived Ratio for the Prediction of Difficult Airway in Adult Patients
Kishanbhai D. Shiyal, Hardul V. Modi, Dhara Joshi and Ravikumar M. Parmar
Page: 100-104 | Received 20 Nov 2023, Published online: 05 Jan 2024
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Abstract
Airway management is crucial in anesthesia, with difficulty contributing to a significant proportion of anesthesia‐related deaths. Accurate pre‐operative prediction of difficult airways is essential for patient safety. Despite various clinical screening tests, their sensitivity and specificity for predicting difficult laryngoscopy are unsatisfactory. Imagistic techniques, including ultrasonography (USG), offer promising non‐invasive tools for dynamic airway assessment. The hyomental distance ratio (HMDR) is explored for its potential in predicting difficult laryngoscopy. A study involving 137 adult patients undergoing elective surgery was conducted to measure and compare HMD and HMDR for predicting difficult laryngoscopy. Exclusion criteria included age <18 and >60 years, BMI >29 kg mG², emergency surgery, airway or head/neck pathology and more. Clinical and ultrasonographic airway assessments were performed and laryngoscopy was graded using Cormack Lehane classification. Statistical analyses were conducted to evaluate the diagnostic accuracy of various tests. Among the 50 patients included, 22% experienced difficult laryngoscopy (CL grade 3 and 4). Demographic profiles were comparable between easy and difficult laryngoscopy groups. HMDR2 demonstrated superior diagnostic accuracy, with 100% sensitivity and 97.44% specificity. Various tests, including HMDR2, were compared based on sensitivity, specificity, positive predictive value and negative predictive value. HMDR2 consistently outperformed other tests in diagnostic accuracy. This study concludes that the HMDR, specifically the ratio in the maximum hyperextended position to that in the neutral position (HMDR2), exhibits superior diagnostic accuracy in predicting difficult laryngoscopy compared to other sonographic indicators. With an optimal threshold of 1.2, HMDR2 achieved 100% sensitivity and 97.47% specificity for predicting difficult laryngoscopy and intubation in adult patients. The study emphasizes the potential of ultrasound‐derived HMDR2 as a valuable tool in preoperative airway assessment.
How to cite this article:
Kishanbhai D. Shiyal, Hardul V. Modi, Dhara Joshi and Ravikumar M. Parmar. To Study the Ultrasound Based Assessment of Hyomental Distance in Different Position and Its
Derived Ratio for the Prediction of Difficult Airway in Adult Patients.
DOI: https://doi.org/10.36478/10.59218/makrjms.2024.4.100.104
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2024.4.100.104