Dataset Information

Acoustic features as novel predictors of difficult laryngoscopy in orthognathic surgery: an observational study.

ABSTRACT:

Background

The evaluation of the difficult intubation is an important process before anaesthesia. The unanticipated difficult intubation is associated with morbidity and mortality. This study aimed to determine whether acoustic features are valuable as an alternative method to predict difficult laryngoscopy (DL) in patients scheduled to undergo orthognathic surgery.

Methods

This study included 225 adult patients who were undergoing elective orthognathic surgery under general anaesthesia with tracheal intubation. Preoperatively, clinical airway evaluation was performed, and the acoustic data were collected. Twelve phonemes {[a], [o], [e], [i], [u], [ü], [ci], [qi], [chi], [le], [ke], and [en]} were recorded, and their formants (f1-f4) and bandwidths (bw1-bw4) were extracted. Difficult laryngoscopy was defined as direct laryngoscopy with a Cormack-Lehane grade of 3 or 4. Univariate and multivariate logistic regression analyses were used to examine the associations between acoustic features and DL.

Results

Difficult laryngoscopy was reported in 59/225 (26.2%) patients. The area under the curve (AUC) of the backward stepwise model including en_f2 [odds ratio (OR), 0.996; 95% confidence interval (CI), 0.994-0.999; P=0.006], ci_bw4 (OR, 0.997; 95% CI, 0.993-1.000; P=0.057), qi_bw4 (OR, 0.996; 95% CI, 0.993-0.999; P=0.017), le_f3 (OR, 0.998; 95% CI, 0.996-1.000; P=0.079), o_bw4 (OR, 1.001; 95% CI, 1.000-1.003; P=0.014), chi_f4 (OR, 1.003; 95% CI, 1.000-1.005; P=0.041), a_bw4 (OR, 0.999; 95% CI, 0.998-1.000; P=0.078) attained a value of 0.761 in the training set, but a value of 0.709 in the testing set. The sensitivity and specificity of the model in the testing set are 86.7% and 63.0%, respectively.

Conclusions

Acoustic features may be considered as useful predictors of DL during orthognathic surgery.

SUBMITTER: Xia M

PROVIDER: S-EPMC8506731 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Acoustic features as novel predictors of difficult laryngoscopy in orthognathic surgery: an observational study.

Xia Ming M Cao Shuang S Zhou Ren R Wang Jia-Yi JY Xu Tian-Yi TY Zhou Zhi-Kai ZK Qian Yan-Min YM Jiang Hong H

Annals of translational medicine 20210901 18

<h4>Background</h4>The evaluation of the difficult intubation is an important process before anaesthesia. The unanticipated difficult intubation is associated with morbidity and mortality. This study aimed to determine whether acoustic features are valuable as an alternative method to predict difficult laryngoscopy (DL) in patients scheduled to undergo orthognathic surgery.<h4>Methods</h4>This study included 225 adult patients who were undergoing elective orthognathic surgery under general anaes ...[more]

PMID: 34734018

Similar Datasets

Project description:BackgroundGeneral anesthesia is not without morbidity. One of the well-known life-threatening events associated with general anesthesia is difficult airway which can happen during induction of anesthesia while attempting to insert the endotracheal tube with the aid of a laryngoscope. Difficult intubation, inadequate ventilation, and esophageal intubation are the principal causes of death or brain damage related to airway manipulation.ObjectiveThe main objective of this study was to assess the magnitude and predictors for difficult laryngoscopy and intubation among surgical patients who underwent elective surgery under general anesthesia with endotracheal intubation at Tikur Anbessa Specialized Hospital from February 1 to March 30, 2019.Materials &methodAn institutional based cross sectional study was conducted from February 1 to March 30, 2019 on patients who underwent elective surgery under general anesthesia with endotracheal intubation. Data on socio-demographic characteristics, preanesthetic airway assessment and laryngoscopic view were collected. Data were analyzed by SPSS Version 20.0. Chi- square test, binary logistic regression and multivariate analysis were performed. Tables and texts were used to present data. A p value less than 0.05 was considered as statistically significant.ResultsThe magnitude of difficult laryngoscopy, difficult intubation, and failed intubation were 12.2%, 6.1%, and 0.67%, respectively. Upper Lip Bite Test (ULBT) had a higher sensitivity (90.2%) and negative predictive value of 85.3%. Mallampati had a sensitivity of 45.8% and negative predictive value of 86% in predicting difficult laryngoscopy. Mallampati grade, thyromental distance and ratio of height to thyromental distance (HRTMD) have also showed greater sensitivity (69.6%, 58.3% and 47.8%, respectively) when compared to other tests in predicting difficult intubation. Mallampati class, upper lip bite test (ULBT) and inter-incisor distance (IID) are independent predictors for difficult laryngoscopy (p < 0.05). Furthermore, Mallampati class, Thyromental distance and ratio of height to thyromental distance (HRTMD) are identified as independent predictors of difficult intubation (p < 0.001).Conclusionand recommendation: Mallampati class, Thyromental distance and Ratio of height to Thyromental distance (HRTMD) can predict the probability of difficult endotracheal intubation in adult patients. Whereas, Mallampati class and upper lip bite test (ULBT) predicts higher probability for difficult laryngoscopy.

Project description:Unexpected difficult airway management can cause significant morbidity and mortality in patients admitted for elective procedures. Ultrasonography is a promising tool for perioperative airway assessment, nevertheless it is still unclear which sonographic parameters are useful predictors of difficult laryngoscopy and tracheal intubation. To determine the ultrasonographic predictors of a difficult airway that could be applied for routine practice, a systematic review and meta-analysis was conducted. Literature search was performed on PubMED, Web of Science and Embase using the selected keywords. Human primary studies, published in English with the use of ultrasonography to prediction of difficult laryngoscopy or tracheal intubation were included. A total of 19 articles (4,570 patients) were analyzed for the systematic review and 12 articles (1,141 patients) for the meta-analysis. Standardized mean differences between easy and difficult laryngoscopy groups were calculated and the parameter effect size quantified. A PRISMA methodology was used and the critical appraisal tool from Joanna Briggs Institute was applied. Twenty-six sonographic parameters were studied. The overall effect of the distance from skin to hyoid bone (p = 0.02); skin to epiglottis (p = 0.02); skin to the anterior commissure of vocal cords (p = 0.02), pre-epiglottis space to distance between epiglottis and midpoint between vocal cords (p = 0.01), hyomental distance in neutral (p < 0.0001), and extended (p = 0.0002) positions and ratio of hyomental distance in neutral to extended (p = 0.001) was significant. This study shows that hyomental distance in the neutral position is the most reliable parameter for pre-operative airway ultrasound assessment. The main limitations of the study are the small sample size, heterogeneity of studies, and absence of a standardized ultrasonographic evaluation method [Registered at International prospective register of systematic reviews (PROSPERO): number 167931].

Dataset Information

Acoustic features as novel predictors of difficult laryngoscopy in orthognathic surgery: an observational study.

Background

Methods

Results

Conclusions

Publications

Acoustic features as novel predictors of difficult laryngoscopy in orthognathic surgery: an observational study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets