Sonographic upper airway evaluation for prediction of difficult laryngoscopy

Airwaymanagement is one of the critical skills mastered by anaesthesiologists and itis their prime responsibility. Suboptimal airway management is a major cause ofpatient morbidity and mortality. Unanticipated difficultlaryngoscopy and intubation remains one of the most important concerns andchallenges in routine anaesthesia practice. Accurate airway assessment mayreduce the number of unanticipated difficult laryngoscopy and intubation, aswell as enable modification of initial airway management plan. The currently employed routine clinical airway assessment parameters when usedalone or in combination are however unable to predict difficult laryngoscopyand intubation with satisfactory sensitivity and specificity.Ultrasoundmachines are now widely available in operating rooms and is becoming aninherent part of anaesthesiologist’s armamentarium for vascular access andregional anaesthesia. Ultrasound is safe, non-invasive, portable, easilyreproducible  and gives real time images. Sonography has been used for airwayassessment and has been evolving as a useful tool for this purpose. Encouragingresults have been obtained in few studies utilising the sonographic parametersfor assessment of airway. However, there are no establishedstandard sonographic parameters to predict difficult laryngoscopy. Hence, thepresent study is designed to evaluate any correlation between sonographicallyassessed parameters and the grade of difficulty at direct laryngoscopy.