Ultrasound Predictors of Difficult Airway in Adults

NCT07383610 | Completed

• 1 other identifier: 2023/10-19
• Study Type: observational
• Target: 400
• Locations: 1 country
• Sites: 1

Brief Summary

Difficult airway management is a major cause of perioperative complications. Standard bedside airway assessment tests may have limited ability to predict difficult intubation and difficult mask ventilation. This prospective observational study aims to evaluate whether preoperative ultrasound measurements of airway structures (such as skin-to-epiglottis distance, tongue thickness, and pre-epiglottic space) can predict difficult intubation and difficult mask ventilation in adult patients undergoing surgery under general anesthesia.

Conditions

Difficult Intubation; Difficult Mask Ventilation; Difficult Airway

Keywords

Airway Ultrasonography; Ultrasound; Difficult Airway Prediction; Anesthesia

Outcome Measures

Primary Outcomes (2)

• Number of Participants with Difficult Intubation

  Difficult intubation was defined as requiring two or more intubation attempts (≥2 attempts) during induction of general anesthesia.

  During induction of anesthesia (intraoperative)

• Number of Participants with Difficult Mask Ventilation

  Difficult mask ventilation was defined as the need for two-handed mask ventilation or inability to ventilate adequately using a face mask

  During induction of anesthesia (intraoperative)

Study Arms (1)

Cohort 1: Adult patients undergoing surgery under general anesthesia

Adult patients (18-70 years, ASA I-III) scheduled for elective surgery under general anesthesia requiring orotracheal intubation. Preoperative clinical airway assessment and ultrasonographic airway measurements were recorded, and intraoperative intubation and mask ventilation outcomes were evaluated

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients aged 18-70 years (ASA I-III) scheduled for elective surgery under general anesthesia requiring orotracheal intubation

You may qualify if:

• Age 18-70 years
• ASA physical status I-III
• Elective surgery under general anesthesia requiring orotracheal intubation
• Written informed consent

You may not qualify if:

• Refusal to participate
• Emergency surgery
• Pregnancy
• Known upper airway pathology or previous airway surgery
• Restricted mouth opening (\<3 cm)
• Cervical spine instability or significant limitation of neck mobility
• Morbid obesity (BMI ≥40 kg/m²)
• Obstructive upper airway masses (e.g., head and neck tumors)
• Prior neck radiotherapy
• Clinically relevant neck masses
• Major facial/mandibular trauma or craniofacial anomalies

Sponsors & Collaborators

• Kutahya Health Sciences University: lead

Study Sites (1)

Kütahya Health Sciences University

Kütahya, Kütahya, 3100, Turkey (Türkiye)

Location

Related Publications (1)

• 1. Cook TM, MacDougall-Davis SR. Complications and failure of airway management. Br J Anaesth. 2012;109 Suppl 1(suppl 1):i68-i85. 2. Apfelbaum JL, Hagberg CA, Connis RT, Abdelmalak BB, Agarkar M, Dutton RP, et al. 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway. Anesthesiology. 2022;136(1):31-81. 3. Roth D, Pace NL, Lee A, Hovhannisyan K, Warenits AM, Arrich J, et al. Airway physical examination tests for detection of difficult airway management in apparently normal adult patients. Cochrane Database Syst Rev. 2018;5(5):CD008874. 4. Shiga T, Wajima Z, Inoue T, Sakamoto A. Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance. Anesthesiology. 2005;103(2):429-37. 5. Detsky ME, Jivraj N, Adhikari NK, Friedrich JO, Pinto R, Simel DL, et al. Will This Patient Be Difficult to Intubate?: The Rational Clinical Examination Systematic Review. JAMA. 2019;321(5):493-503. 6. Singh M, Chin KJ, Chan VW, Wong DT, Prasad GA, Yu E. Use of sonography for airway assessment: an observational study. J Ultrasound Med. 2010;29(1):79-85. 7. Kundra P, Mishra SK, Ramesh A. Ultrasound of the airway. Indian J Anaesth. 2011;55(5):456-62. 8. Marchis IF, Negrut MF, Blebea CM, Crihan M, Alexa AL, Breazu CM. Trends in Preoperative Airway Assessment. Diagnostics (Basel). 2024;14(6). 9. Yao W, Wang B. Can tongue thickness measured by ultrasonography predict difficult tracheal intubation? Br J Anaesth. 2017;118(4):601-9. 10. Daggupati H, Maurya I, Singh RD, Ravishankar M. Development of a scoring system for predicting difficult intubation using ultrasonography. Indian J Anaesth. 2020;64(3):187-92. 11. Sotoodehnia M, Khodayar M, Jalali A, Momeni M, Safaie A, Abdollahi A. Prediction of difficult laryngoscopy / difficult intubation cases using upper airway ultrasound measurements in emergency department: a prospective observational study. BMC Emerg Med. 2023;23(1):78

  RESULT

Study Officials

• Serkan Telli, MD

  Kutahya Health Sciences University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: January 26, 2026
• First Posted: February 3, 2026
• Study Start: October 1, 2023
• Primary Completion: October 1, 2024
• Study Completion: October 1, 2024
• Last Updated: February 5, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)