Validation of neck length and neck circumference together as predictors of difficult airway in overweight and obese females
Year: 2025
Type: article
Study design: Observational Study
Abstract: Objectives Neck circumference (NC) and neck length are used as predictors of a difficult airway. There is inconsistency in the literature regarding the factors that predict a difficult airway in obese patients. The primary objective was to assess the correlation between neck length and neck circumference with the intubation difficulty score (IDS). The secondary aim was to examine the correlation of IDS with the modified mallampati class (MMP), thyromental distance (TMD), thyromental height, the neck circumference-to-thyromental distance ratio (NC:TMD), and the presence of a neck hump. Material and Methods This double-blind, cross-sectional study involved 50 female patients, aged 18-60 years, with a body mass index (BMI) ≥ 25 kg m -2 , who were planned for elective surgery requiring general anesthesia. Participants who were pregnant, had a BMI below 25 kg m -2 , required rapid sequence intubation, had a history of cervical spine injury, or were male were excluded from the study. The IDS was utilized to assess intubation difficulty. Neck length and neck circumference were measured, and their predictive ability for a difficult airway was compared with IDS. Additionally, IDS was analyzed in relation to MMP class, thyromental distance, NC:TMD, thyromental height, and the presence of a neck hump. Data analysis was done using one-way ANOVA with Tukey’s post hoc tests, the chi-square test, and student’s t-test, with p ≤ 0.05 set as the significance level. Results Neck length (<7 cm) alone showed a strong correlation with a difficult airway. An average neck length of 4.9 ± 0.63 cm has been positively correlated with IDS >5, while a neck length of 6.7 ± 0.47 cm corresponded to IDS 0. An NC of ≥36 cm was significantly linked to moderate to difficult intubation, as determined by the IDS. A mean NC of 41.91 ± 4.98 cm was associated with IDS > 5, and a NC of 37 ± 1.23 cm was associated with IDS 0. The MMP class and NC:TMD ratio were also effective in predicting a difficult airway. Conclusion In our study, we observed a statistically significant correlation (p-value < 0.05) between both neck length and NC with the IDS in overweight and obese females.
Authors: Ruchi Kapoor, Meghna Choudhary, Ashok Kumar Saxena, Naveen Mathew A, Parul Jindal
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4411387944