Mandibular Protrusion Research Articles

Drug induced sleep endoscopy and simultaneous polysomnography to predict the effectiveness of mandibular advancement device in obstructive sleep apnea treatment.

To evaluate whether mandibular advancement device therapy is recommended in patients affected by obstructive sleep apnea. In order to predict oral appliances therapy response, drug induced sleep endoscopy with cardio-respiratory polygraphy and mandibular advancement device simulator was carried out. Patients in which upper airway obstruction was resolved on all levels and AHI was normalized (< 5/h), were referred for oral appliance therapy. At 5 months follow up, a cardio-respiratory polygraphy with MAD was performed. 36 patients who have evidence of resolution of UA collapse and AHI below 5 events per hour, were referred for MAD therapy. At follow up, the mean AHI decreased from 29.1 ± 13.1 to 3.3/h ± 1.9 (p < 0.001). All the patients were responders. Combining the evaluation of drug induced sleep endoscopy and cardio-respiratory polygraphy data simultaneously during mandibular protrusion, has the potential to be a useful tool for prediction of MAD therapy response.

Morphometric Tomographic Analysis of the Head of the Tridactyl Humanoid Specimen from Nasca-Peru

Objective: To report the tomographic and morphometric analysis of the head of the tridactyl humanoid specimen from Nazca, Peru. Method: A qualitative case study approach. RadiAnt DICOM Viewer software version 4.2.1 was used to analyze lengths, diameters, and volume in tomographic images of the head. The morphological biometric analysis applied anthropometric methods using some craniometric points and cephalometric angles. Results and Discussion: As a result, it is reported that there are atypical, strange, and exceptional morphometric imaging features in the cephalic segment of specimen M01. The cephalometric analysis based on the ANB angle revealed a class II skeletal pattern, and according to the Bjorl-Jarabak analysis, it has a convex facial profile with hypodivergent growth (brachyfacial). The patient also has maxillary biprotrusion, severe protrusion of upper and lower incisors, loss of teeth, presence of root remnants, severe dental abrasion, non-assessable canine class, absence of three third molars and ocular protrusion. Based on craniometric points, the SNA angle (Sella, Nasion and Point A) and the SNB angle (Sella, Nasion and Point B) maxillary protrusion and mandibular protrusion were diagnosed. Implications of the research: It is concluded that the combination of uncommon morpho-anatomical features in the maxillofacial and cranial massif do not correspond to a human craniofacial biotype, but could be considered as suggestive findings of morpho-anatomical features typical of a hominid species similar to humans. Originality/Value: The expansion of biometric and morphoanatomical data of the head reinforces the hypothesis that morphologically it would be a non-human hybrid species.

Recent evaluation and analysis of the clinical effect of two closed treatment methods in children with intracapsular condyle fracture

Objective: To summarize and analyze clinical characteristics of pediatric mandibular condylar fractures and the long-term therapeutic effects of closed treatment. Methods: A retrospective study was conducted for pediatric condylar fracture in the Department of Oral and Maxillofacial Surgery of Peking University School and Hospital of Stomatology from October 2015 to October 2019, including 33 males (67.3%) and 16 females (32.7%), with an average age of (8.3±2.1) years old. According to the treatment methods, the children were divided into two groups: group A was a removable occlusal splint accompanied with functional exercise, group B was a pure functional exercise. Forty-nine cases (76 sides) children with intracapsular condylar fracture were included in this study. Twenty-three cases in group A and 26 cases in group B. The maximum month opening increased from (20.0±6.2) mm to (46.0±5.3) mm 6 months after closed treatment. Subjective evaluation, special examination, qualitative analysis and quantitative analysis of imaging were used to evaluate the condylar remodeling and functional recovery of temporomandibular joint in two groups of children after closed treatment of intracapsular condyle fracture. Results: There was no significant difference in subjective evaluation, maximum opening examination, mouth open-type, mandibular protrusion, lateral movement and qualitative analysis of imaging at the six-month follow-up after injury. Quantitative imaging measurements showed that the condylar anteroposterior diameter and condylar height in Group B were significantly higher than those in Group A after 1 year of injury. Conclusions: Closed treatment for pediatric condylar fractures can achieve satisfactory results. After 6 months of injury, the children in the two groups could recover the temporomandibular joint function and promote the condylar adaptative remodeling.

Multidisciplinary Treatment of A Class III Patient With Giant Open Bite Secondary to Macroglossia

Skeletal Class III malocclusion deformity is one of the most common maxillofacial malocclusions in East Asia and is either due to maxillary retrusion, mandibular protrusion, or both. It could cause functional and aesthetic problems. This deformity could be attributed to either hereditary or environmental factors or both. Tongue lymphangioma-induced skeletal class III deformity with open bite is a relatively rare condition. Therefore, its management poses a significant challenge to surgeons and requires a multidisciplinary approach. In this case report, such deformity was successfully managed through a multidisciplinary approach.

Determinants of Cormack–Lehane grading for glottic exposure in microlaryngeal surgery in Middle Delta Egyptian patients

BackgroundLaryngoscopy is a diagnostic procedure utilized in critical care to examine and visualize the larynx through the diversion of upper airway structures. Its primary functions are airway management and tracheal intubation. The objective of this study was to detect the predictors of laryngeal exposure during microlaryngeal surgery (MLS).MethodsAn analytical cross-sectional study was conducted on a consecutive sample of 100 patients presenting laryngeal lesions that were trans-orally microsurgeries to treat various glottic diseases (biopsies revealed 68% benign lesions such as vocal fold polyps, cysts, and nodules, and 32% glottic masses) and prepared for MLS.ResultsThis study included 100 patients presenting laryngeal lesions from both sexes with the age of 47.0 ± 14.7 years, in multivariate logistic regression analysis, all these parameters were significant predictors for Cormack–Lehane and Italian Grading (P < 0.05). Body mass index (BMI) (OR = 3.449, 95% CI = 2.463–8.187), mandibular protrusion test (OR = 2.981, 95% CI = 1.922–4.044), mento-sternal length (OR = 3.722, 95% CI = 1.980–7.794), and atlanto-occipital joint (AOJ) extension (OR = 1.572, 95% CI = 1.865–4.263). Cormack–Lehane and Italian Grading was significantly associated with BMI, mandibular protrusion test, Mallampati Index, mento-thyroid, mento-sternal length, and AOJ extension, it increased with BMI of > 35, with more protruded mandible (class C), higher Mallampati Index (class III) and shorter mento-sternal distance (≤ 12.5 cm).ConclusionsDuring microlaryngeal surgery, BMI, mandibular protrusion test, Mallampati Index, mento sternal and AOJ extension were significant predictors of Cormack–Lehane and Italian Grading which makes it easier for laryngeal exposure.

Postoperative maxillary stability after Le Fort I osteotomy using a u-HA/PLLA system: three-dimensional analysis by surface superimposition based on virtual Le Fort I osteotomy

The postoperative stability achieved with Le Fort I osteotomy (LFI) using bioabsorbable systems remains controversial. A new method – multipoint measurement method – was devised for detailed three-dimensional examination of postoperative stability following LFI, and the stability after LFI when using SuperFIXSORB-MX made of u-HA/PLLA was investigated. Thirty-one patients who underwent LFI using SuperFIXSORB-MX were evaluated retrospectively. The patients were divided into four malocclusion types: open bite, mandibular retrognathia, mandibular protrusion, and facial asymmetry. Seven maxillary reference points were measured three-dimensionally using computed tomography scans obtained preoperatively (T0), 4 days post-surgery (T1), and 1 year post-surgery (T2). Surgical changes (T1–T0) and the postoperative discrepancy (T2–T1) of the maxilla were analysed to evaluate postoperative stability by surface superimposition of the virtual LFI segments. Postoperative discrepancy was the largest for the facial asymmetry type, ranging from 0.75 ± 0.45 mm to 0.98 ± 0.52 mm in three-dimensional distance (minimum to maximum mean ± standard deviation values for the individual reference points). The relapse at U1 was 16% in the transverse axis, and the anterior nasal spine moved further upward by 17% of the amount of movement of the maxilla. Fixation with SuperFIXSORB-MX was considered to be within clinically acceptable limits.

A case of masticatory muscle tendon–aponeurosis hyperplasia revealed after orthognathic surgery

AbstractBackgroundMasticatory muscle tendon–aponeurosis hyperplasia (MMTAH) is a condition in which the tendons and fascia of the masticatory muscles, including the masseter muscle, overgrow.Case presentationA 36‐year‐old male underwent orthognathic surgery to correct malocclusion with mandibular protrusion. A strong skeletal relapse was observed immediately after surgery. The patient was clinically diagnosed with MMTAH after examination. He opened his mouth up to 46 mm after coronoidectomy and masseter muscle tendonectomy surgery.ConclusionBased on the available previous reports, this is the first report of MMTAH resulting from strong skeletal relapse after orthognathic surgery.

Effect of condylar rotation on the stress environment of the temporomandibular joint in patients with mandibular protrusion

PurposeThe study aims to analyse the effects of condylar rotation on the biomechanical environment of the TMJ after bilateral sagittal split ramus osteotomy (BSSRO) through the finite element method (FEM). MethodsThirteen patients with mandibular prognathism and twenty-three normal subjects were recruited. The three-dimensional (3D) models were reconstructed. 13 representative morphological parameters were measured for comparison. A patient was selected to perform virtual BSSRO surgery by rotating the condyles in MIMICS. The preoperative and postoperative 3D models of the patient were subsequently imported into ABAQUS for finite element analysis. The preoperative and postoperative stresses and joint spaces in the TMJs were investigated. ResultsThe maxillofacial morphologies of the patients with mandibular protrusion was significantly different from those of the asymptomatic subjects (P<.05). Stresses in the postoperative group were lower than those in the preoperative group. The rotation of the condyle could cause the variations in stress levels and joint spaces within the TMJs. Inward and upward rotation of the condyle was associated with higher stress in the TMJ, whereas the lowest stress was observed when the condyle remained stationary following surgical intervention. SignificanceLateral, medial and superior joint spaces were more related to the stresses in the TMJs. The condyle should be kept in place as much as possible to avoid disrupting the balance of the TMJ in patients with mandibular protrusion.

Sella turcica and facial bones: Morphological integration in the human fetal cranium.

The cranial base plays a significant role in facial growth, and closer analyses of the morphological relationship between these two regions are needed to understand the morphogenesis of the face. Here, we aimed to study morphological integration between the sella turcica (ST) and facial bones during the fetal period using geometric morphometrics. Magnetic resonance images of 47 human fetuses in the Kyoto Collection, with crown-rump lengths of 29.8-225 mm, were included in this study. Anatomical homologous landmarks and semilandmarks were registered on the facial bones and the midsagittal contour of the ST, respectively. The shape variations in the craniofacial skeleton and the ST were statistically investigated by reducing dimensionality using principal component analysis (PCA). Subsequently, the morphological integration between the facial bones and ST was investigated using two-block partial least squares (2B-PLS) analysis. PCA showed that small specimens represented the concave facial profile, including the mandibular protrusion and maxillary retrusion. The 2B-PLS showed a strong integration (RV coefficient = 0.523, r = .79, p < .01) between the facial bones and ST. The curvature of the anterior wall of the ST was highly associated with immature facial morphology characterized by a concave profile. The strong integration between the two regions suggested that the anterior ST may be associated with facial morphology. This result quantitatively confirms previous studies reporting ST deformities in facial anomalies and induces further research using postnatal subjects.

Mandibular advancement device in obstructive sleep apnea treatment: what happens to the condyle position and patient response?

This study aims primarily to assess the mandibular condyles and patient response to MAD therapy using cone-beam computed tomography (CBCT). Also, the study proposes to analyze whether variations in condylar position, OSA severity and mandibular protrusion influence patient response. 23 patients diagnosed with mild/moderate OSA and treated with MAD comprised the sample. Clinical, CBCT, and PSG assessments were conducted at baseline and with MAD in therapeutic protrusion (4-6 months of MAD use). The condyle position was vertically and horizontally evaluated at baseline and at the therapeutic protrusion. The condyle position significantly changed with MAD, showing anterior (7.3 ± 2.8mm; p < 0.001) and inferior (3.5 ± 1mm; p < 0.001) displacement. Patients with mild OSA required more protrusion (p = 0.02) for improvement. Responders exhibited a significantly prominent (p = 0.04) anterior baseline condyle position. A negative modest correlation was found between treatment response and baseline condyle anterior position (p = 0.03; r=-0.4), as well as between OSA severity and the percentage of maximum protrusion needed for therapeutic protrusion (p = 0.02; r=-0.4). The patient protrusion amount did not predict condylar positional changes. Neither condyle position, OSA severity, nor therapeutic protrusion were predictors of MAD treatment response. MAD resulted in anterior and inferior condylar displacement, and the amount of protrusion did not predict condylar positional changes. Responders showed a more anterior baseline condyle position. OSA severity and mandibular protrusion did not predict treatment response.

4D Analysis of the Mandibular Protrusion Movement in Patients with Severe Malocclusion Before and After Orthognathic Surgery

4D Analysis of the Mandibular Protrusion Movement in Patients with Severe Malocclusion Before and After Orthognathic Surgery

A comparative assessment of condylar inclination in completely edentulous patients using cone beam computed tomography and Arcus digma II

Statement of problemCondylar inclination affects denture fabrication and placement, especially when bilateral balanced occlusion is provided. However, comparisons between radiographic techniques and clinical procedures are lacking. PurposeThe purpose of this clinical study was to investigate the effects of cone beam computed tomography (CBCT) and Arcus digma II on horizontal condylar inclination and bilateral balanced occlusion. Material and methodsTwelve completely edentulous individuals were provided with complete dentures with teeth in bilateral balanced occlusion. The horizontal condylar angle was measured using CBCT and the Arcus digma II with a 6-mm mandibular protrusion. The CBCT had a real-time 3D image, and the Arcus digma II method recorded mandibular movement using electronic sensors. To evaluate the clinical performance, the horizontal condylar angle was measured using the 2 methods and applied to the semi-adjustable articulator to evaluate the balanced occlusion. The Shapiro-Wilk test was used to assess normality, and a paired t test was used to assess the normally distributed data (α=.05). ResultsThe horizontal condylar guidance angle values for both sides of Arcus digma II were significantly higher than from CBCT (P<.05). No difference was found in the clinical performance of balanced occlusion of complete dentures in the 2 methods. ConclusionsThe Arcus digma II method yielded higher horizontal condylar angle measurements than from CBCT. However, no significant difference was found between Arcus digma II and CBCT in terms of the effect on balanced occlusion. Arcus digma II appears to be a reliable technique for measuring the horizontal condylar angle, similar to CBCT, and can be used as an alternative method.

DIFFICULT MASK VENTILATION IN OBESE PATIENTS: ANALYSIS OF PREDICTIVE FACTOR

American Society of Anesthesiologists (ASA), DMV is defined as the clinical situation. developing when it not possible for the anesthesiologist to provide adequate ventilation because of one or more of the following problems: inadequate mask seal, excessive gas lead or excessive resistance to the ingress or egress of gas. Materials and Methods:-This is a prospective randomised observational study in patients with morbid obesity (n = 90body mass index[BMI] &gt;30 kg/m2. Patients were preoperatively assessed for age, height, weight, BMI,modified Mallampati test results,mouth opening [inter- incisor gap (cm)], thyromental distance (cm), sternomental distance (cm), mandibular protrusion,mandibular length (ML), neck circumference (NC) by anesthesiologist. Mask ventilation was graded according to four point Han scale. Conclusion:In conclusion, male sex, snoring history, NC ≥43 cm, ML ≥9 cm and NC/TMD &lt;5 cm were correlated with DMV in obese patients.According to the current investigation the three predictive factors are strongly associated.In the present study we demonstrated that (a)age &gt;49 years, (B)Neck circumference &gt;43cm,and (C) and short neck are strongly associated with DMV in obese patients.

Cranial musculature of batoids: A standardized nomenclature.

Batoids (rays and skates) are cartilaginous fishes whose jaws are not articulated directly to the neurocranium. The only point of contact between them are the hyomandibular cartilages, resulting in a unique mandibular suspension called euhyostyly. Due to this decoupling of the jaws from the skull, muscles play an essential role in modulating mandibular movements during the feeding process, especially during mandibular protrusion. The main objectives of our study were: (1) to examine the mandibular musculature of eight batoid species from different orders in the Batoidea and (2) establish a standardized musclulature terminology for future comparative myological studies in batoids. For each muscle bundle, the general characteristics of each cranial muscle were described and their origin and insertions were identified. The number of muscle bundles differed intraspecifically. On the dorsal surface, we reported the first evidence of the presence of the precranial muscle (PCM) in U. halleri, as well as the ethmoideo-parethmoidalis muscle (ETM) in R. velezi, P. glaugostigma and Z. exasperata; in addition, the insertion of the spiracularis muscle (SP) extended to the ventral surface of the oropharyngeal tract in myliobatiforms. On the ventral surface of the head, both N. entemedor and M. californica exhibited additional muscles in the mandibular area. These muscles were renamed as part of the standardization of mandibular terminology: the depressor mandibularis minor (DMM) in N. entemedor and the adductor mandibulae profundus (AMP) in M. californica. The standardization of terminology is essential for futures studies of the mandibular apparatus in batoids, to facilitate the morphological description of muscles in species without anatomical accounts and for continuity in broader comparative analyses.

Quantitative evaluation of the cheek area after maxillary advancement and rotation by orthognathic surgery in skeletal maxillary retrusion

AbstractAimNo quantitative methods for evaluating the cheek line after orthognathic surgery have been reported. The aim of this study was to clarify the effects of orthognathic surgery on the cheek line using computer‐assisted image analysis.MethodsThis retrospective study involved 101 female participants who underwent orthognathic surgery consisting of both Le Fort I osteotomy and bilateral sagittal split ramus osteotomy. Lateral cephalometric photographs of the patients were analyzed using computer‐assisted image analysis to determine the area surrounded by the cheek line (iCA). The ratio of the postoperative iCA to the preoperative iCA was calculated and denoted as the iCA ratio.ResultsParticipants were categorized into four diagnostic groups according to their malocclusion: Group 1 (maxillary retrusion with mandibular protrusion); Group 2 (maxillary retrusion with mandibular retrusion); Group 3 (maxillary protrusion with mandibular protrusion); and Group 4 (maxillary protrusion with mandibular retrusion). The mean iCA ratio of Group 1 was 1.61, which was the largest value among the four groups. Analyses were performed for Groups 1 and 2 because Groups 3 and 4 had too few cases. When measuring the distances of maxillary forward or backward movement, the iCA ratio was significantly correlated with the distance of maxillary forward movement (correlation coefficients: 0.25 and 0.22 respectively), but not the degree of rotation of maxillary and mandibular movement.ConclusionMaxillary forward movement by Le Fort I osteotomy contributed to the increase of iCA in the profile, which may help to predict the effects of orthognathic surgery on the cheek line.

Hard to Soft Tissue Profile Changes in Skeletal Class III Dentofacial Deformities After Maxillary Advancement and Mandibular Setback Orthognathic Surgery

Objective To correlate the sagittal hard tissue movement and soft tissue changes among patients with skeletal class III malocclusion following bimaxillary orthognathic surgery. Material and Methods Fifty-nine subjects with skeletal class III malocclusion treated consecutively with maxillary advancement and mandibular setback were assessed for skeletal and soft tissue linear changes using presurgical (T1) and post-treatment (T2) lateral cephalograms. Pearson’s correlation coefficient test was used to correlate hard and soft tissue parameters. Results The sagittal hard tissue movement and soft tissue changes for all the parameters assessed in maxilla and mandible showed statistically significant correlations. The ratios of changes for the maxillary protrusion [N-A (HP)] to horizontal subnasale (Sn), superior labial sulcus (Sls), and labrale superioris (Ls) were 0.574:1, 0.703:1, and 0.721:1 respectively. The ratio of horizontal labrale inferioris (Li), mentolabial fold (Mlf), and soft tissue (Pg′) to mandibular protrusion [N-B (HP)] were 0.992:1, 0.970:1, and 0.590:1 respectively and to chin protrusion [N-Pg (HP)] were 1.293:1, 1.252:1, and 1.001:1, respectively. The ratios were different for males and females in maxilla and mandible. Conclusion Sagittal hard tissue movement and soft tissue changes are significantly correlated. The soft tissue movement in the mandible were more proportionate compared to the maxilla. The sagittal hard tissue to soft tissues movement ratios were greater in maxilla and lesser at pogonion and mentolabial sulcus in females compared to males. The ratios obtained can be used for predicting postsurgical soft tissue changes.

Temporomandibular joint stress analysis of patients with different mandibular deformities during unilateral molar occlusion

Mandibular prognathism, retrusion and deviation are common mandibular deformities. They can lead to functional and aesthetic problems due to their important role in the oral system. Different from other occlusions, unilateral molar occlusion often occurs during mastication, which has a deep impact on the functions of temporomandibular joints (TMJs). Therefore, the study of unilateral molar occlusion is of great importance and significance to the daily life of patients with mandibular deformities. A total of 35 individuals were involved in this study, including 11 asymptomatic subjects, 10 patients with mandibular prognathism, 5 patients with mandibular retrusion and 9 patients with mandibular deviation. Finite element (FE) models corresponding to the unilateral molar occlusion were constructed. During unilateral molar occlusion, mandibular deformity increases the pressure on the condyle and articular disc. Compared with mandibular protrusion or retraction, facial asymmetry will significantly increase the stress of TMJ. Chewing on the non-deviated side also will lead to higher stress in the TMJ of patients with mandibular deviation. Therefore, patients with mandibular deviation have the highest risk of temporomandibular disorder (TMD), and it is recommended that patients with mandibular deviation chew bilaterally or with the deviated side.

Biometric Morpho-Anatomical Characterization and Dating of The Antiquity of A Tridactyl Humanoid Specimen: Regarding The Case of Nasca-Peru

Objective: Report the bioarchaeological case and perform the morpho-anatomical biometric characterization and dating of the antiquity of a tridactyl humanoid specimen found in Nasca-Peru. Method: Qualitative approach study of a bioarchaeological case report of a tridactyl humanoid specimen. The imaging analysis applied the RadiAnt DICOM Viewer software version 2024.1 and the age dating technique used radiocarbon 14. Results and Discussion: The tomographic imaging analysis showed that the specimen is a desiccated humanoid body with a biological architecture similar to that of a human, but with many morphological and anatomical structural differences such as the lack of hair and ears, an elongated skull and an increase in cranial volume. (30% greater than humans); maxillary and mandibular protrusion as well as protrusion of the eyeballs, absence of the fifth lumbar vertebra, tridactyly in both hands and feet, in addition to different foci of arthropathies. Carbon-14 dating analysis of the specimen gave an age of 1771 ± 30 years, corresponding to 240 AD-383 AD. (after Christ). Implications of the research: If it is demonstrated with further studies that this is a new humanoid species, it would have a strong impact on biology and science and scientific-historical and socio-cultural implications. Originality/Value: The sui generis theme and the applied scientific methodology grant originality and value is given by the significance of the revealed findings, which ipso facto reveal the non-human humanoid biological existence.

German guidelines for airway management 2023.

The German airway management guidelines are intended to serve as an orientation and decision-making aid and thus contribute to the optimal care of patients undergoing anesthesiologic- and intensive medical care. As part of the pre-anesthesiologic evaluation, anatomical and physiological indications for difficult mask ventilation and intubation shall be evaluated. This includes the assessment of mouth opening, dental status, mandibular protrusion, cervical spine mobility and existing pathologies. The airway shall be secured while maintaining spontaneous breathing if there are predictors or anamnestic indications of difficult or impossible mask ventilation and/or endotracheal intubation. Various techniques can be used here. If there is an unexpectedly difficult airway, avideo laryngoscope is recommended after unsuccessful direct laryngoscopy, consequently avideo laryngoscope must be available at every anesthesiology workplace. The airway shall primarily be secured with avideo laryngoscope in critically ill- and patients at risk of aspiration. Securing the airway using translaryngeal and transtracheal techniques is the "ultima ratio" in airway management. The performance or supervision of airway management in the intensive care unit is the responsibility of experienced physicians and nursing staff. Appropriate education and regular training are essential. Clear communication and interaction between team members are mandatory before every airway management procedure. Once the airway has been secured, the correct position of the endotracheal tube must be verified using capnography.

The Diagnostic Value of Sub-mental Fat Measurement for Prediction of Difficult Laryngoscopy and Intubation: A Randomized Prospective Study

Background: Difficult airway management poses a high-risk procedure, potentially leading to patient mortality. Despite significant advancements in modern anesthesia over the years, there remains a lack of a single reliable tool for predicting difficult airways. Objectives: This study aims to examine neck fat diameter as a potential predictor of airway difficulty. Methods: Two hundred fifty patients participated in the study. Airway parameters, including Mallampati score, mandibular protrusion, upper lip bite test, thyromental distance, neck movements, and neck fat diameter, were documented. Results: Among our study population, 48 patients experienced difficult intubation. The Mann-Whitney test revealed that submental fat was significantly greater in the difficult intubation group (P-value &lt; 0.001). Based on the best subset variable selection, submental fat, thyromental distance (model 1), and age (model 2) were selected to participate in the multivariate regression model. Each one mm increase in neck fat was associated with a 30% increase in the odds of difficult intubation (P-value &lt; 0.001) in the univariate logistic model. After adjusting for thyromental distance, age, and gender, the odds of difficult intubation were approximately 2 times higher in patients with 1 mm more neck fat (P-value 0.007). The area under the curve of the Receiver Operating Characteristics curve and McFadden's pseudo-R squared of the multivariate model were 0.998 and 0.91, respectively. Conclusions: Neck fat diameter serves as a reliable and straightforward predictor of airway difficulty and can be used alone or in conjunction with other predictors for the prediction of difficult airway management.