Can the "Face Index"; an Anthropometric Measurement, Predict Difficult Laryngoscopy and Intubation?

NCT07366177 | Not Yet Recruiting

• 1 other identifier: NTasFACE
• Study Type: observational
• Target: 1,000
• Locations: 0 countries
• Sites: N/A

Brief Summary

Patient safety is the cornerstone of anesthetic practice, and maintaining adequate respiration represents its most critical initial step. In situations where spontaneous breathing cannot be sustained-such as during general anesthesia-the airway must be mechanically secured. While simple face masks may be sufficient in some cases, endotracheal intubation remains the most reliable method for airway control in conditions associated with respiratory depression. Airway management may be challenging due to various patient-related anatomical factors, including facial and mandibular structure, obesity, limited mouth opening, facial hair, sunken cheeks, wide facial morphology, and a short or muscular neck. These challenges are collectively described as difficult ventilation and difficult intubation (cannot ventilate-cannot intubate), which may occur unexpectedly or be anticipated. A difficult airway is defined as difficulty encountered by a trained anesthesiologist in face mask ventilation, tracheal intubation, or both. Several predictors of difficult airway are widely accepted, such as thyromental and sternomental distances, neck circumference, Mallampati classification, upper lip bite test, mouth opening, and interincisor distance. Thorough preoperative airway evaluation is mandatory, as difficult mask ventilation and failed intubation remain major contributors to anesthesia-related morbidity and mortality. Although numerous studies have examined these predictors, research focusing on facial morphology and anthropometric indices-particularly the face index-is extremely limited. Facial morphology varies considerably among individuals and can be evaluated anthropometrically using simple, noninvasive tools such as a digital caliper. Anthropometric analysis is commonly applied in forensic medicine and reconstructive surgery but has rarely been incorporated into airway assessment. This study aims to introduce face index analysis as a novel predictor of difficult airway alongside conventional methods. By evaluating measurements such as trichion-gnathion distance, total facial index, upper facial index, and nasal index, the study investigates whether airway difficulty can be predicted using a single index value. All measurements are standard, noninvasive, and routinely performed during preoperative assessment.

Conditions

Anesthesia Intubation Complication; Intubation; Difficult or Failed; Laryngoscopy; Anesthesia Morbidity

Keywords

Difficult airway, face index, anesthesia

Outcome Measures

Primary Outcomes (1)

• Face index and face mask ventilation

  Face index is useful measurement about difficult laryngoscopy management in anesthesia

  365 days

Secondary Outcomes (1)

• Face index and intubation

  365 days

Interventions

Face index OTHER

Face index is an anthropometric measurement

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients over 18 years of age who will undergo general anesthesia and intubation

You may qualify if:

• All adult patients over the age of 18 who have given written consent to undergo elective and/or emergency surgery under general anesthesia and be intubated in the operating rooms of our hospital's main building and annex building

You may not qualify if:

• Patients with a prior history of difficult airway/difficult intubation, those who have undergone facial, neck, or airway surgery, those with deformities or scars in the facial and neck area due to burns or injuries, those with previous or recent tracheostomy, those with facial deformities due to any cause (congenital or acquired pathologies), and those with communication problems and who are uncooperative during measurements will be excluded from the study. Children and pregnant patients will not be included.

Sponsors & Collaborators

• Ordu University: lead

Related Publications (6)

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  PMID: 34762729 RESULT

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  PMID: 36256766 RESULT

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  PMID: 9232526 RESULT

• Garber DA, Beverley SM, Coen DM. Demonstration of circularization of herpes simplex virus DNA following infection using pulsed field gel electrophoresis. Virology. 1993 Nov;197(1):459-62. doi: 10.1006/viro.1993.1612.

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Study Officials

• Nilay Taş, Prof. Dr.

  Ordu University School of Medicine, Türkiye

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Yasir İlyas, Ass. Prof.

CONTACT

+904522252344; yasirilyas@odu.edu.tr

Halil Yılmaz, Ass. Prof.

CONTACT

+904522252344; halilyilmaz855@gmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prof. Dr.

Study Record Dates

• First Submitted: January 18, 2026
• First Posted: January 26, 2026
• Study Start: March 1, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): March 1, 2027
• Last Updated: January 26, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share