Preoperative radiological indicators for prediction of difficult laryngoscopy in patients with atlantoaxial dislocation
Background: Difficult airway remains a great challenge in patients with atlantoaxial dislocation (AAD). Preoperative evaluation and reliable prediction are required to facilitate the airway management. We aimed to screen out reliable radiological indicators for prediction of difficult laryngoscopy i...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023106438 |
| _version_ | 1797337013718876160 |
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| author | Yinyin Qu Yang Tian Jingchao Fang Yinglun Tian Dengyang Han Linyu Ren Nanfang Xu Chao Wang Xiangyang Guo Shenglin Wang Yongzheng Han |
| author_facet | Yinyin Qu Yang Tian Jingchao Fang Yinglun Tian Dengyang Han Linyu Ren Nanfang Xu Chao Wang Xiangyang Guo Shenglin Wang Yongzheng Han |
| author_sort | Yinyin Qu |
| collection | DOAJ |
| description | Background: Difficult airway remains a great challenge in patients with atlantoaxial dislocation (AAD). Preoperative evaluation and reliable prediction are required to facilitate the airway management. We aimed to screen out reliable radiological indicators for prediction of difficult laryngoscopy in patients with AAD. Methods: A retrospective nested case-control study within a single center longitudinal AAD cohort was conducted to investigate the radiological indicators. All the patients with difficult laryngoscopy from 2010 to 2021 were enrolled as the difficult laryngoscopy group. Others in the cohort without difficult laryngoscopy were randomly selected as the non-difficult laryngoscopy group by individually matching with the same gender, same surgery year, and similar age (±5 years) at a ratio of 6:1. Radiological data on preoperative lateral X-ray images between the two groups were compared. Bivariate logistic regression model was applied to screen out the independent predictive indicators and calculate the odds ratios of indicators associated with difficult laryngoscopy. Receiver operating characteristic curve and area under the curve (AUC) were used to describe the discrimination ability of indicators. Results: A total of 154 patients were finally analyzed in this study. Twenty-two patients with difficult laryngoscopy and matched with 132 controls. Four radiological parameters showed significant difference between the two groups. Among which, ΔC1C2D (the difference of the distance between atlas and axis in the neutral and extension position), owned the largest AUC. Conclusions: ΔC1C2D could be a valuable radiologic predictor for difficult laryngoscopy in patients with AAD. |
| first_indexed | 2024-03-08T09:03:15Z |
| format | Article |
| id | doaj.art-36cf9285ba2a4cf6a96fb349850313c1 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-08T09:03:15Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-36cf9285ba2a4cf6a96fb349850313c12024-02-01T06:31:52ZengElsevierHeliyon2405-84402024-01-01101e23435Preoperative radiological indicators for prediction of difficult laryngoscopy in patients with atlantoaxial dislocationYinyin Qu0Yang Tian1Jingchao Fang2Yinglun Tian3Dengyang Han4Linyu Ren5Nanfang Xu6Chao Wang7Xiangyang Guo8Shenglin Wang9Yongzheng Han10Department of Anesthesiology, Peking University Third Hospital, Beijing, ChinaDepartment of Anesthesiology, Peking University Third Hospital, Beijing, ChinaDepartment of Radiology, Peking University Third Hospital, Beijing, ChinaDepartment of Orthopaedics, Peking University Third Hospital, Beijing, ChinaDepartment of Anesthesiology, Peking University Third Hospital, Beijing, ChinaDepartment of Anesthesiology, Peking University Third Hospital, Beijing, ChinaDepartment of Orthopaedics, Peking University Third Hospital, Beijing, ChinaDepartment of Orthopaedics, Peking University Third Hospital, Beijing, ChinaDepartment of Anesthesiology, Peking University Third Hospital, Beijing, ChinaDepartment of Orthopaedics, Peking University Third Hospital, Beijing, China; Corresponding author.Department of Anesthesiology, Peking University Third Hospital, Beijing, China; Corresponding author.Background: Difficult airway remains a great challenge in patients with atlantoaxial dislocation (AAD). Preoperative evaluation and reliable prediction are required to facilitate the airway management. We aimed to screen out reliable radiological indicators for prediction of difficult laryngoscopy in patients with AAD. Methods: A retrospective nested case-control study within a single center longitudinal AAD cohort was conducted to investigate the radiological indicators. All the patients with difficult laryngoscopy from 2010 to 2021 were enrolled as the difficult laryngoscopy group. Others in the cohort without difficult laryngoscopy were randomly selected as the non-difficult laryngoscopy group by individually matching with the same gender, same surgery year, and similar age (±5 years) at a ratio of 6:1. Radiological data on preoperative lateral X-ray images between the two groups were compared. Bivariate logistic regression model was applied to screen out the independent predictive indicators and calculate the odds ratios of indicators associated with difficult laryngoscopy. Receiver operating characteristic curve and area under the curve (AUC) were used to describe the discrimination ability of indicators. Results: A total of 154 patients were finally analyzed in this study. Twenty-two patients with difficult laryngoscopy and matched with 132 controls. Four radiological parameters showed significant difference between the two groups. Among which, ΔC1C2D (the difference of the distance between atlas and axis in the neutral and extension position), owned the largest AUC. Conclusions: ΔC1C2D could be a valuable radiologic predictor for difficult laryngoscopy in patients with AAD.http://www.sciencedirect.com/science/article/pii/S2405844023106438Airway managementAtlantoaxial dislocationRadiographyPreoperative careAnesthesiaDifficult laryngoscopy |
| spellingShingle | Yinyin Qu Yang Tian Jingchao Fang Yinglun Tian Dengyang Han Linyu Ren Nanfang Xu Chao Wang Xiangyang Guo Shenglin Wang Yongzheng Han Preoperative radiological indicators for prediction of difficult laryngoscopy in patients with atlantoaxial dislocation Heliyon Airway management Atlantoaxial dislocation Radiography Preoperative care Anesthesia Difficult laryngoscopy |
| title | Preoperative radiological indicators for prediction of difficult laryngoscopy in patients with atlantoaxial dislocation |
| title_full | Preoperative radiological indicators for prediction of difficult laryngoscopy in patients with atlantoaxial dislocation |
| title_fullStr | Preoperative radiological indicators for prediction of difficult laryngoscopy in patients with atlantoaxial dislocation |
| title_full_unstemmed | Preoperative radiological indicators for prediction of difficult laryngoscopy in patients with atlantoaxial dislocation |
| title_short | Preoperative radiological indicators for prediction of difficult laryngoscopy in patients with atlantoaxial dislocation |
| title_sort | preoperative radiological indicators for prediction of difficult laryngoscopy in patients with atlantoaxial dislocation |
| topic | Airway management Atlantoaxial dislocation Radiography Preoperative care Anesthesia Difficult laryngoscopy |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023106438 |
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