Assessment of Tongue Thickness Using Ultrasound for Predicting Difficult Airway: Study

Recently published research paper investigates the potential of ultrasound-based measurement of tongue thickness in predicting difficult laryngoscopy and intubation. The study involved 85 patients undergoing elective surgeries under general anesthesia, where tongue thickness was measured using submental ultrasonography. The findings revealed that patients with difficult intubation had significantly higher tongue thickness compared to those without difficult intubation. The ratio of tongue thickness to thyromental distance was also significantly higher in the difficult intubation group. The study calculated the sensitivity, specificity, positive and negative predictive value, and accuracy of tongue thickness for predicting difficult intubation. The results showed a sensitivity of 72% and a specificity of 59%, with an overall accuracy of 72%.

Conclusion and Recommendations

The paper concluded that ultrasound-based assessment of tongue thickness can be a useful predictor of difficult airway, with higher accuracy than other clinical parameters. It highlighted the increasing familiarity of anesthesiologists with ultrasound machines and the potential for ultrasound-based airway assessment as a bedside, non-invasive, and convenient method for predicting difficult airway. The paper also discussed the limitations of the study, including the need for larger studies in different populations and emphasized the importance of combining tongue thickness measurement with other clinical and ultrasound airway parameters for a comprehensive assessment of difficult airway.

Study's Implications

Overall, the study provides valuable insights into the utility of ultrasound-based measurement of tongue thickness as a potential predictor of difficult intubation, offering potential benefits in preanesthetic evaluation and preparedness for handling the airway in clinical practice.

Key Points -

- The research paper investigates the potential of ultrasound-based measurement of tongue thickness in predicting difficult laryngoscopy and intubation. The study involved 85 patients undergoing elective surgeries under general anesthesia, where tongue thickness was measured using submental ultrasonography.

- Findings revealed that patients with difficult intubation had significantly higher tongue thickness compared to those without difficult intubation. The ratio of tongue thickness to thyromental distance was also significantly higher in the difficult intubation group. The study calculated the sensitivity, specificity, positive and negative predictive value, and accuracy of tongue thickness for predicting difficult intubation. The results showed a sensitivity of 72% and a specificity of 59%, with an overall accuracy of 72%.

- The paper concluded that ultrasound-based assessment of tongue thickness can be a useful predictor of difficult airway, with higher accuracy than other clinical parameters. It highlighted the potential for ultrasound-based airway assessment as a non-invasive, convenient method for predicting difficult airway, but also discussed the need for larger studies in different populations and the importance of combining tongue thickness measurement with other clinical and ultrasound airway parameters for a comprehensive assessment of difficult airway.

References –

Furia, Jhanvi Sunil; Nadkarni, Manali Mohan. Ultrasound-based assessment of tongue thickness for prediction of difficult laryngoscopy and intubation. Journal of Anaesthesiology Clinical Pharmacology 40(2):p 235-241, Apr–Jun 2024. | DOI: 10.4103/joacp.joacp_395_22.