Ultrasonographic Airway Assessment and VIDIAC Score

Evaluation of the Relationship Between Ultrasonographic Airway Measurements, Videolaryngoscopic Intubation Findings, and the Video Intubation Difficulty Assessment Classification (VIDIAC) Score in Adult Patients: A Prospective Observational Study

This prospective observational study aims to evaluate the relationship between preoperative ultrasonographic airway measurements and the Video-Intubation Difficulty Assessment Classification (VIDIAC) score in adult patients undergoing endotracheal intubation under general anesthesia. The study will investigate whether airway ultrasound parameters can predict difficult videolaryngoscopic intubation and assess their association with the Cormack-Lehane classification, intubation time, and other airway management outcomes.

Study Overview

• Status: Not yet recruiting
• Conditions: Difficult Intubation; Difficult Airway; Vidiac Score; Videolaryngoscopic Intubation

Detailed Description

Difficult airway management is a major cause of anesthesia-related morbidity and mortality. Airway ultrasonography has emerged as a noninvasive tool for evaluating airway anatomy and may help predict difficult intubation. The Video-Intubation Difficulty Assessment Classification (VIDIAC) score is a recently developed and standardized method for assessing videolaryngoscopic intubation difficulty.

This prospective, observational, single-center study aims to evaluate the relationship between preoperative ultrasonographic airway measurements and the VIDIAC score in adult patients undergoing elective surgery under general anesthesia. Ultrasonographic measurements, including tongue depth, tongue thickness, hyomental distance, hyoid depth, hyoid width, and distance from skin to epiglottis, will be obtained before anesthesia induction.

Videolaryngoscopic intubation will be performed by anesthesiologists blinded to the ultrasound findings, and the VIDIAC score will be recorded. The study will assess the correlation between ultrasonographic airway measurements and the VIDIAC score, as well as the ability of these measurements to predict difficult videolaryngoscopic intubation.

• Study Type: Observational
• Enrollment (Estimated): 100

Contacts and Locations

• Study Contact: Name: Betül Çiftçi Kurt; Phone Number: 5301785995; Email: betulciftcikurt@gmail.com
• Study Contact Backup: Name: Hatice Selçuk Kuşderci; Phone Number: 0 505 215 98 96; Email: drkusderci@hotmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of adult patients aged 18-80 years who are scheduled to undergo elective surgical procedures requiring endotracheal intubation under general anesthesia at Samsun City Hospital. Eligible patients with ASA physical status I-III who provide written informed consent and meet all inclusion criteria will be consecutively enrolled in the study.

Description

Inclusion Criteria:

• Adults aged 18 to 80 years.
• American Society of Anesthesiologists (ASA) physical status I-III.
• Patients scheduled for endotracheal intubation under general anesthesia.
• Patients who provide written informed consent.

Exclusion Criteria:

• Known airway abnormalities.
• Head and neck tumors.
• Patients with a tracheostomy.
• Pregnant patients.
• Emergency surgical procedures.
• Patients with limited cervical mobility.
• Patients with facial trauma.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To evaluate the relationship between preoperative ultrasonographic airway measurements and the VIDIAC score.	The relationship between preoperative ultrasonographic airway measurements and the Videolaryngoscopic Intubation and Difficult Airway Classification (VIDIAC) score will be evaluated in adult patients undergoing videolaryngoscopic intubation. The simplified VIDIAC score classifies patients as easy (-1 or 0), moderate (1), hard (2), or severe (≥3), with higher scores indicating greater videolaryngoscopic intubation difficulty. Correlations between ultrasonographic airway measurements and the VIDIAC score will be analyzed.	During videolaryngoscopic intubation

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intubation Time	The duration of videolaryngoscopic intubation, measured from insertion of the videolaryngoscope into the oral cavity until successful placement of the endotracheal tube.	During videolaryngoscopic intubation
First-Attempt Intubation Success Rate	The proportion of patients successfully intubated on the first videolaryngoscopic attempt without the need for additional intubation attempts.	During videolaryngoscopic intubation
Requirement for Additional Airway Maneuvers	The need for additional airway maneuvers during videolaryngoscopic intubation, including external laryngeal manipulation, repositioning, use of a bougie, stylet adjustment, or other adjunctive techniques to facilitate successful intubation.	During videolaryngoscopic intubation
Occurrence of Oxygen Desaturation	The occurrence of oxygen desaturation during videolaryngoscopic intubation, defined as a decrease in peripheral oxygen saturation (SpO₂) below 90%.	During videolaryngoscopic intubation
Number of Intubation Attempts	The total number of videolaryngoscopic intubation attempts required to achieve successful endotracheal intubation. An intubation attempt is defined as insertion of the videolaryngoscope into the oral cavity with the intention of placing the endotracheal tube.	During videolaryngoscopic intubation
Incidence of Difficult Videolaryngoscopic Intubation	The incidence of difficult videolaryngoscopic intubation will be determined using the Videolaryngoscopic Intubation and Difficult Airway Classification (VIDIAC) score. The simplified VIDIAC score is classified as follows: easy (-1 or 0), moderate (1), hard (2), and severe (≥3), with higher scores indicating greater videolaryngoscopic intubation difficulty. Patients classified as having difficult videolaryngoscopic intubation according to the predefined VIDIAC criteria will be identified, and the incidence will be calculated.	During videolaryngoscopic intubation
Cormack-Lehane Grade	The Cormack-Lehane Grading System will be used to assess the laryngeal view obtained during videolaryngoscopic intubation. The scale ranges from Grade I to Grade IV (minimum: Grade I; maximum: Grade IV), where higher grades indicate poorer laryngeal visualization and greater difficulty with tracheal intubation. The recorded grade will be analyzed for its association with preoperative ultrasonographic airway measurements and the VIDIAC score.	During videolaryngoscopic intubation

Collaborators and Investigators

• Sponsor: Samsun University

Study record dates

Study Major Dates

• Study Start (Estimated): June 22, 2026
• Primary Completion (Estimated): January 22, 2027
• Study Completion (Estimated): January 22, 2027

Study Registration Dates

• First Submitted: July 2, 2026
• First Submitted That Met QC Criteria: July 2, 2026
• First Posted (Actual): July 9, 2026

Study Record Updates

• Last Update Posted (Actual): July 21, 2026
• Last Update Submitted That Met QC Criteria: July 17, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: GOKAEK 2026/11/19

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No