• P Mathew, V Ashok, M M Siraj, V Grover, and D Sethuraman.
• Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
• J Postgrad Med. 2019 Jul 1; 65 (3): 164-168.

BackgroundPreoperative airway evaluation in children is an important part of routine preanesthetic evaluation before surgery. External airway measurements, viz., thyromental, mentohyoid, and sternomental distances, while being growth dependent, could identify pediatric patients with potentially difficult airways.ObjectivesThis study was conducted to validate the age- and height-based formulae, derived from a previous study conducted in our institute, to predict thyromental distance, sternomental distance, and mentohyoid distance in relation with the height and age of pediatric patients.DesignProspective cross-sectional single arm observational study.SettingTertiary level university teaching hospital from July 2015 to December 2016.PatientsChildren (202) in the age group of 3-15 years with no obvious external airway anomaly scheduled for elective surgery under general anesthesia.Outcomes MeasuredThe thyromental, mentohyoid, and sternomental distances were measured preoperatively. The same parameters were then calculated based on age- and height-related formulae derived in the earlier study.ResultsBland-Altman analysis of the sample patients showed a mean difference (bias) between measured and calculated values ranging from 0.14 to -0.60 (3 - 13%). Overall agreement in terms of bias were found to be more with height-based equation for mentohyoid distance and thyromental distance and age-based equation for sternomental distance.ConclusionOur study validates the formulae derived in the earlier study to predict thyromental, mentohyoid, and sternomental distances in children with no obvious external airway anomalies. Further studies are needed to extend the applicability of these formulae in obese children and those with craniofacial anomalies coming for general anesthesia and surgery.

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