An Evaluation of Ultrasound Measurements of Anterior Neck Soft Tissue and Other Predictors of Difficult Laryngoscopy in Morbidly Obese Patients

Abstract

Objective: The aim of this study was to compare the ultrasonography (USG) measurements of anterior neck soft tissue and other clinical screening tests used to evaluate difficult laryngoscopy in morbidly obese patients. Materials and Methods: A total of 130 morbidly obese patients were scheduled for laparoscopic bariatric surgery. USG examination was performed of the vocal cords, thyroid isthmus, and suprasternal notch. Results: Analysis was made of 74 patients. Difficult laryngoscopy was considered as grade 3 or 4 on the Cormack and Lehane scale. In seven (9.5%) patients the classification was made of difficult laryngoscopy. The incidence of difficult laryngoscopy was significantly higher in patients with older age, hypertension, and obstructive sleep apnea syndrome. Grades of ≥5 on the intubation difficulty scale, which is a requirement for a styleted endotracheal tube and a high number of intubation attempts, were found to be significantly higher in the difficult laryngoscopy group. Sternomental distances for difficult and easy laryngoscopy were 11.5 ± 3.75 and 14.18 ± 2.63 cm, respectively. Conclusion: USG measurements of the anterior soft tissue thickness of the neck remain debatable for the prediction of difficult laryngoscopy in the literature. The results of this study demonstrated that USG measurements of anterior neck soft tissue have no advantage in the determination of difficult laryngoscopy in morbidly obese patients scheduled for bariatric surgery.