Related Experiment Video
Updated: Jan 17, 2026
Point-of-Care Ultrasound: A Review of Ultrasound Parameters for Predicting Difficult Airways
Published on: April 7, 2023
Could mandibular profile angle or inter-pterygoid distance provide a novel method for predicting difficult
E Sule Ozdemir Sezgi1,2, M Murat Sayin3,4, Savaş Altinsoy3,4
1Department of Anesthesiology and Intensive Care, Diskapi Training and Research Hospital, Gülhane School of Medicine, University of Health Sciences, Ankara, Türkiye - elifsule-91@hotmail.com.
Novel mandibular measurements, the "mandibular profile angle" and "inter-pterygoid distance," significantly improve the prediction of difficult laryngoscopy compared to standard tests. These findings offer enhanced patient safety and procedural outcomes in preoperative assessments.
Area of Science:
- Anesthesiology and airway management.
- Anatomical and anthropometric predictors of airway difficulty.
Background:
- Existing preoperative tests for difficult airways lack sufficient accuracy.
- Need for improved methods to predict difficult laryngoscopy during preoperative evaluations.
Purpose of the Study:
- To investigate novel mandibular structures and angles as predictors of difficult laryngoscopy.
- To compare the accuracy of new mandibular measurements against established airway assessment tests.
Main Methods:
- Prospective study of 1001 patients undergoing general anesthesia with oral intubation.
- Evaluation of standard tests (MMT, thyromental distance, etc.) and novel parameters (mandibular profile angle, inter-pterygoid distance).
- Difficult laryngoscopy defined as Cormack-Lehane grade III or IV.
Main Results:
- Mandibular profile angle (sensitivity 83%, NPV 96%) and inter-pterygoid distance (sensitivity 82%, NPV 96%) showed higher accuracy than Modified Mallampati Test (MMT) (sensitivity 46%, NPV 89%).
- Area under the curve (AUC) values were high for both novel parameters (0.89 and 0.90).
- Optimal cut-off values identified for both mandibular measurements.
Conclusions:
- Mandibular structures offer reliable threshold values for predicting difficult laryngoscopy.
- Novel mandibular measurements can enhance the accuracy and robustness of preoperative airway assessments.
- Integration of these novel measurements may improve patient safety and procedural outcomes.
