Ultrasound predictive parameters of difficult airway in thyroid surgery: a pilot study

Area of Science:

• Anesthesiology
• Medical Imaging
• Otorhinolaryngology

Background:

• Difficult airway management is critical during general anesthesia, especially in thyroid surgery where enlarged goiters can distort the airway.
• Airway distortion in compressive goiter poses challenges for tracheal intubation.
• Ultrasonography is emerging as a valuable tool for airway assessment.

Purpose of the Study:

• To evaluate ultrasound-based measurements of specific airway parameters in patients with compressive goiter and tracheal deviation.
• To assess the correlation between pre-anesthetic ultrasound findings and Cormack-Lehane grades during tracheal intubation.

Main Methods:

• Ultrasound measurements, including the distance between the skin and retro-isthmic trachea (DSRIT) and the distance between the sub-isthmic trachea and carotid artery (DCSIT), were performed in 13 patients.
• These ultrasound parameters were measured before induction of general anesthesia.
• Measurements were compared with Cormack-Lehane laryngoscope grades obtained during intubation.

Main Results:

• Ultrasound measurements of DSRIT and DCSIT were obtained in patients with compressive goiter and tracheal deviation.
• A correlation was observed between pre-intubation ultrasound airway measurements and the Cormack-Lehane grades.
• This suggests ultrasound can provide useful information for predicting intubation difficulty.

Conclusions:

• Pre-anesthetic ultrasonography can effectively measure key airway parameters in patients undergoing thyroidectomy for compressive goiter.
• Ultrasound-based airway assessment shows potential for predicting tracheal intubation difficulty in this patient population.
• This technique may improve anesthetic management and patient safety in complex airway cases.