Novel radiological indicators may accurately predict difficult laryngoscopy in cervical spondylosis patients: Study

Study Findings

The study findings suggest that LMHT and the combined predictive model incorporating LMAT are valuable predictors for anticipating difficult laryngoscopy in patients with cervical spondylosis. These radiological indicators can enhance airway management safety by improving preoperative assessment and informing anesthetic planning for this high-risk population.

Key Points

1. The study introduced novel radiological indicators from lateral cervical X-rays in the extended head position to improve the accuracy of predicting difficult laryngoscopy in patients with cervical spondylosis.

2. The radiological indicators analyzed were Mandibular Length (ML), Laryngeal Height (LH), Larynx-Mandibular Angle Test (LMAT), and Larynx-Mandibular Height Test (LMHT).

3. Binary logistic regression analysis identified inter-incisor gap (IIG), upper lip bite test (ULBT), neck circumference (NC), and LMAT as independent predictors of difficult laryngoscopy.

4. A novel combined predictive model was derived, which included IIG, ULBT, NC, and LMAT, and had an AUC of 0.776, exceeding the individual AUC of 0.677 for LMHT.

5. The study findings suggest that LMHT and the combined predictive model incorporating LMAT are valuable predictors for anticipating difficult laryngoscopy in patients with cervical spondylosis.

6. These radiological indicators can enhance airway management safety by improving preoperative assessment and informing anesthetic planning for this high-risk population.

Reference –

Li, J., Tian, Y., Wang, M. et al. Radiological indicators and a novel combined predictive model for anticipating difficult laryngoscopy in cervical spondylosis patients: a prospective cohort study. BMC Anesthesiol 24, 446 (2024). https://doi.org/10.1186/s12871-024-02826-w