Imaging Tests for Predicting the Presence of Difficult Airway in Head and Neck Cancer Patients Undergoing Otorhinolaryngological Surgery

Abstract

Patients with head and neck cancers represent a challenge for the surgical team from many points of view, but, especially, the surgical moment where greater stress generated corresponds to the perioperative management of the airway, because in many occasions we can face unexpected situations, most of the time, incidental findings can hinder ventilation and endotracheal intubation. Gutierrez et al., in 2018, decided to study four tomography measures and their correlation in anesthesia records with airway management difficulties. Material and methods: A retrospective, observational study was carried out in 104 patients operated by head and neck cancers over a period of 36 months, only in those with access to tomographic records. Four tomographic measurements were considered and were statistically related to the extreme degrees of visualization of the glottis (Cormack III-IV) and the presence of the physical examination of Mallampati III-IV. Results: After performing a multivariate model in the group of extreme degrees of visualization of the glottis, the results were not statistically significant (p > 0.05; 95% CI: 0.030-2.31: EPI/ PPW, 0.018-1.37 TB/PPW). In the Mallampati III-IV group, in the multivariate model only the VC/PPW showed clinically significant results (p < 0.05; 95% CI: 0.104-8.53). Conclusions: Tomographic measurements and the physical examination predictors could represent a useful guide in the prediction of the difficult airway in these patients.