Comparison of upper airway ultrasound parameters with Wilson’s score for prediction of difficult airway in adult patients: A prospective observational study
Background: Pre-operative airway assessment is an essential component of General Anaesthesia. Adequate airway assessment helps better prepare with
airway gadgets during intubation and prevents complications associated with laryngoscopy and intubation attempts. Conventional airway assessment tools
used clinical parameters like Wilson’s score. We aimed to compare this with the ultrasound airway parameters in predicting difficult airways.
Materials and Methods: The study included 130 patients scheduled for general anaesthesia with endotracheal intubation. A clinical airway assessment was
done and Wilson`s score was noted. Ultrasound airway assessment was done and parameters like distance from Skin to the epiglottis, geniohyoid muscle
thickness, skin to the hyoid bone, and skin to the vocal cord were noted. Laryngoscopy was performed by independent anesthesiologists who were blinded to
the parameters, and the Cormack-Lehane grading was recorded.
Results: The distances from the skin to the epiglottis at the thyrohyoid membrane and from the skin to the vocal cords have demonstrated high sensitivity in
predicting a difficult airway, with values of 89.74% and 92.31%, respectively. The cutoff values for these measurements are 1.81 cm and 0.78 cm, with
corresponding AUROC values of 0.83 and 0.80, indicating strong predictive accuracy. In contrast, Wilson’s score showed a much lower sensitivity of only
20.5% with an AUROC value of 0.764.
Conclusion: Compared to Wilson’s score, ultrasound airway assessment is more accurate in predicting difficult airways. Ultrasound can be an easy, rapid,
non-invasive bedside screening tool for evaluating the airway. The Distance of skin to vocal cords (DSVC) and skin to epiglottis (DSE) were more sensitive
in predicting difficult airways.
airway gadgets during intubation and prevents complications associated with laryngoscopy and intubation attempts. Conventional airway assessment tools
used clinical parameters like Wilson’s score. We aimed to compare this with the ultrasound airway parameters in predicting difficult airways.
Materials and Methods: The study included 130 patients scheduled for general anaesthesia with endotracheal intubation. A clinical airway assessment was
done and Wilson`s score was noted. Ultrasound airway assessment was done and parameters like distance from Skin to the epiglottis, geniohyoid muscle
thickness, skin to the hyoid bone, and skin to the vocal cord were noted. Laryngoscopy was performed by independent anesthesiologists who were blinded to
the parameters, and the Cormack-Lehane grading was recorded.
Results: The distances from the skin to the epiglottis at the thyrohyoid membrane and from the skin to the vocal cords have demonstrated high sensitivity in
predicting a difficult airway, with values of 89.74% and 92.31%, respectively. The cutoff values for these measurements are 1.81 cm and 0.78 cm, with
corresponding AUROC values of 0.83 and 0.80, indicating strong predictive accuracy. In contrast, Wilson’s score showed a much lower sensitivity of only
20.5% with an AUROC value of 0.764.
Conclusion: Compared to Wilson’s score, ultrasound airway assessment is more accurate in predicting difficult airways. Ultrasound can be an easy, rapid,
non-invasive bedside screening tool for evaluating the airway. The Distance of skin to vocal cords (DSVC) and skin to epiglottis (DSE) were more sensitive
in predicting difficult airways.