Study of the effect of ultrasonographically calculated volume of thyroid swelling on endotracheal intubation: a prospective observational double-blinded study

Author: 
Pratibha Singh, Shefali Gautam, Anita Malik, Zia Arshad, Shobhna Jafa and Sanjeev Kumar

Introduction: Patients with thyroid swelling are anticipated difficult airway due to the anatomical complications associated with it. This study was done to evaluate the effect of volume of thyroid swelling on endotracheal intubation.
Methods: Eighty patients posted for elective thyroid surgery of either sex, between 18 and 70 years, ASA grade I or II and Mallampati score 1 or 2 were enrolled. Ultrasound volume of thyroid swelling was calculated. After induction of general anaesthesia, tracheal intubation was done and time taken for intubation, Cormack-Lehane score and Intubation Difficulty score were noted.
Results: Mean volume of thyroid swelling was 57.13±46.21 ml. Thyroid volume was found to be positively and significantly correlated with time from insertion of laryngoscope to visualization of glottis (mean time: 14.69±7.94 sec; spearman correlation coefficient, =0.398; p<0.001), time taken for successful intubation (mean time: 37.99±12.66 sec; =0.391; p<0.001), Intubation Difficulty score (mean IDS: 1.75±1.64; =0.602; p<0.001) and Cormack Lehane Score (mean: 1.40±0.56; =0.626; p<0.001). With increase in size of gland, there is increase in the time for intubation, Intubation Difficulty score and Cormack-Lehane score.
Conclusion: The size and volume of thyroid swelling is found to be a good predictor of difficulty in intubation in patients undergoing thyroid surgery.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2019.17864.3403
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