• Feyza Sever and Sengül Özmert.
• Ministry of Health, Ankara City Hospital, Children's Hospital Department of Anesthesiology, Ankara, Turkey.
• Paediatr Anaesth. 2020 Nov 1; 30 (11): 1233-1239.

BackgroundA difficult laryngoscopy in young children can be a stressful situation for the pediatric anesthetist. In recent years, several measurements have been used to obtain difficult laryngoscopy markers in children. However, there is no prospective study in which ultrasonography is expected to be used for this purpose, particularly in the newborn and infant age groups.GoalsIn this study, our goal was to evaluate the relationship between the preoperative airway assessment tools and the difficult laryngoscopic view in neonates and infants.MethodsOur study included newborns and infants undergoing elective surgery requiring intubation under general anesthesia. The following measurements were recorded the following: patients' age, body mass index, thyromental distance, mandibular length, the distance between the lip corner and ipsilateral ear tragus, and the transverse length (measured by hand with sign-middle-ring fingers side by side). In the thyromental distance measurement, the "thyroid notch" was determined by ultrasonography. Glottic structures appearing during laryngoscopy were graded according to the Cormack-Lehane Classification.ResultsOf the 150 patients included in the study, 36 were female, and 92% were under the age of one. The incidence of difficult laryngoscopic views was 8% in the age groups studied, and the frequency of difficult laryngoscopic views in the newborn age group was 14.3%. The relationship between airway assessment tools and the Cormack-Lehane Classification scores was statistically significant. The negative predictive value was high for all values.ConclusionsThe risk of a difficult laryngoscopy increases in children under the age of one. The preoperative airway assessment tools and body mass index had acceptable negative predictive values. We believe that all measurements could be used as markers for difficult laryngoscopy in newborns and infants.© 2020 John Wiley & Sons Ltd.

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