Ultrasound Measurement of Skin-to-Epiglottis Distance for Prediction of Difficult Airway in Adult Patients
Ultrasound Measurement of Skin to Epiglottis Distance for Prediction of Difficult Airway in Adult Patients
Study Overview
Status
Status
Conditions
Conditions
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Almıla G Pamuk, Doç. Dr.
- Phone Number: 03123051207 9005335296325
- Email: gulsunp@yahoo.com
Study Contact Backup
- Name: muhammed r hız, research assistant
- Phone Number: 9003123051207 9005417800327
- Email: drrasithiz@gmail.com
Study Locations
-
-
Altındağ
-
Ankara, Altındağ, Turkey (Türkiye), 06320
- Hacettepe Univercity
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- ≥18 yaş elective surgery
Exclusion Criteria:
- emergency surgery
- head and neck surgery
- pregnant patients
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Skin to epiglottis distance
Time Frame: Preintubation (within 30 minutes before procedure)
|
Distance measured via ultrasound in the anterior neck region
|
Preintubation (within 30 minutes before procedure)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of difficult laryngoscopy (Cormack-Lehane grade ≥ 3)
Time Frame: During intubation procedure (intraoperative period)
|
The proportion of patients with difficult laryngoscopy defined as Cormack-Lehane grade 3 or 4 during direct laryngoscopy.
|
During intubation procedure (intraoperative period)
|
|
Intubation Difficulty Score (IDS)
Time Frame: During intubation procedure
|
Assessment of intubation difficulty using the Intubation Difficulty Score based on number of attempts, operators, alternative techniques, glottic exposure, lifting force, external laryngeal pressure, and vocal cord position.
|
During intubation procedure
|
|
Correlation between ultrasound measurements and Mallampati score
Time Frame: Preoperative assessment
|
Correlation between tracheal diameter and skin to epiglottis distance measured by ultrasound and preoperative Mallampati classification.
|
Preoperative assessment
|
|
Skin-to-Epiglottis Distance Measured by Ultrasound
Time Frame: Immediately before induction of anesthesia
|
Skin-to-epiglottis distance will be measured using ultrasound immediately before anesthesia induction.
The distance is recorded in millimeters (mm) as a continuous variable.
Larger values indicate a greater skin-to-epiglottis distance and may be associated with an increased likelihood of difficult laryngoscopy.
This is not a scored scale; therefore, no predefined minimum or maximum score exists.Cormack-Lehane Grading System.
Scores range from Grade I to Grade IV.
Grade I indicates full visualization of the glottis (easier laryngoscopy), whereas Grade IV indicates that neither the glottis nor the epiglottis is visible (most difficult laryngoscopy).
Higher grades indicate a worse airway view.
|
Immediately before induction of anesthesia
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Almıla g Pamuk, Doç Dr., Hacettepe Univercity
Publications and helpful links
General Publications
- Cook TM, Woodall N, Frerk C; Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011 May;106(5):617-31. doi: 10.1093/bja/aer058. Epub 2011 Mar 29.
- Falcetta S, Cavallo S, Gabbanelli V, Pelaia P, Sorbello M, Zdravkovic I, Donati A. Evaluation of two neck ultrasound measurements as predictors of difficult direct laryngoscopy: A prospective observational study. Eur J Anaesthesiol. 2018 Aug;35(8):605-612. doi: 10.1097/EJA.0000000000000832.
- Gani, E. (2020). Obez hastalarda zor entübasyonun öngörülmesinde ultrasonla ölçülen cilt-epiglot mesafesinin önemi (Tıpta Uzmanlık Tezi). Düzce Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Düzce.
- Uzumcugil F, Celebioglu EC, Ozkaragoz DB, Yilbas AA, Akca B, Lotfinagsh N, Celebioglu B. Body Surface Area Is Not a Reliable Predictor of Tracheal Tube Size in Children. Clin Exp Otorhinolaryngol. 2018 Dec;11(4):301-308. doi: 10.21053/ceo.2018.00178. Epub 2018 Aug 25.
- Ahmad I, El-Boghdadly K, Iliff H, Dua G, Higgs A, Huntington M, Mir F, Nouraei SAR, O'Sullivan EP, Patel A, Rivett K, McNarry AF. Difficult Airway Society 2025 guidelines for management of unanticipated difficult tracheal intubation in adults. Br J Anaesth. 2026 Jan;136(1):283-307. doi: 10.1016/j.bja.2025.10.006. Epub 2025 Nov 7.
- Altinsoy KE, Bayhan BU. Ultrasound-Measured Skin-to-Epiglottis Distance as a Predictor of Difficult Intubation in Obese Patients: A Prospective Observational Study. J Clin Med. 2025 Mar 19;14(6):2092. doi: 10.3390/jcm14062092.
- Sayir TN, Tuncer B, Erkilic E. Evaluation of upper airway ultrasonographic measurements in predicting difficult intubation: A cross-section of the Turkish population. Open Med (Wars). 2024 Aug 21;19(1):20241013. doi: 10.1515/med-2024-1013. eCollection 2024.
- Cinar Kose EO, Tekin M, Cesur S, Cam I, Baykara ZN. Evaluation of neck ultrasound measurements as a difficult airway predictor: A prospective observational study. Medicine (Baltimore). 2024 Jul 19;103(29):e38591. doi: 10.1097/MD.0000000000038591.
- Daggupati H, Maurya I, Singh RD, Ravishankar M. Development of a scoring system for predicting difficult intubation using ultrasonography. Indian J Anaesth. 2020 Mar;64(3):187-192. doi: 10.4103/ija.IJA_702_19. Epub 2020 Mar 11.
- Sotoodehnia M, Rafiemanesh H, Mirfazaelian H, Safaie A, Baratloo A. Ultrasonography indicators for predicting difficult intubation: a systematic review and meta-analysis. BMC Emerg Med. 2021 Jul 3;21(1):76. doi: 10.1186/s12873-021-00472-w.
- Zhang W, Du L, Huang Y, Liu D, Li T, Zheng J. Artificial intelligence for difficult airway assessment: a protocol for a systematic review with meta-analysis. BMJ Open. 2025 Jun 10;15(6):e096744. doi: 10.1136/bmjopen-2024-096744.
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- SBA 26/158
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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