Prediction of difficult laryngoscopy by USG guided quantification of distance of skin to anterior commissure of vocal cord

Abstract

Introduction: The major responsibility of the anaesthesiologist is to provide adequate ventilation to the patient. Most vital element for this is the airway. We have evaluated the feasibility of usg assessment of distance of skin to anterior commissure of vocal cord at anterior neck as an imaging tool in identifying important airway anatomical structures on the anterior aspect of the neck and correlated this with the Cormack Lehane classification of the direct laryngoscopy for prediction of the difficult airway. Method: The present observational study from January 2020 to march 2021 was conducted on 90 patients between the age group of 18 to 65 years, ASA I, II, IIIgrades, scheduled for elective surgery and requiring general anaesthesia with direct laryngoscopy and endotracheal intubation. Modified Mallampati score was noted and distance from skin to anterior commissure of vocal cord at thyroid cartilage followed by modified Cormack lehane score grade on laryngoscopy were noted. Result: With reference to ROC analysis, the optimal cut-off of distance of skin to anterior commissure of vocal cord for the prediction of difficult laryngoscopy was 1.15 cm. Conclusion: We conclude from our study that usg guided measurement of distance of skin to anterior commissure of vocal cord is a good predictor of difficult laryngoscopy.