Nakazawa H, Uzawa K, Tokumine J, Lefor AK, Motoyasu A, Yorozu T. Airway ultrasound for patients anticipated to have a difficult airway: Perspective for personalized medicine. World J Clin Cases 2023; 11(9): 1951-1962 [PMID: 36998948 DOI: 10.12998/wjcc.v11.i9.1951]
Corresponding Author of This Article
Joho Tokumine, MD, PhD, Professor, Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Sinkawa, Mitaka 181-8611, Tokyo, Japan. dg274825@cf6.so-net.ne.jp
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Harumasa Nakazawa, Kohji Uzawa, Joho Tokumine, Akira Motoyasu, Tomoko Yorozu, Department of Anesthesiology, Kyorin University School of Medicine, Mitaka 181-8611, Tokyo, Japan
Alan Kawarai Lefor, Department of Surgery, Jichi Medical University, Shimotsuke 329-0498, Tochigi, Japan
Author contributions: Nakazawa H, Uzawa K, Motoyasu A and Tokumine J helped with literature acquisition and contributed in writing the original daft; Lefor AK contributed in editing the draft; Yorozu T helped in the conceptualization and data validation.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joho Tokumine, MD, PhD, Professor, Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Sinkawa, Mitaka 181-8611, Tokyo, Japan. dg274825@cf6.so-net.ne.jp
Received: December 14, 2022 Peer-review started: December 14, 2022 First decision: January 19, 2023 Revised: January 28, 2023 Accepted: February 27, 2023 Article in press: February 27, 2023 Published online: March 26, 2023
Abstract
Airway ultrasound allows for precise airway evaluation, particularly for assessing the difficult airway and the potential for front of neck access. Many studies have shown that identification of the cricothyroid membrane by airway ultrasound is more accurate than digital palpation. However, no reports to date have provided clinical evidence that ultrasound identification of the cricothyroid membrane increases the success rate of cricothyroidotomy. This is a narrative review which describes patients with difficult airways for whom airway ultrasound may have been useful for clinical decision making. The role of airway ultrasound for the evaluation of difficult airways is summarized and an approach to the use of ultrasound for airway management is proposed. The goal of this review is to present practical applications of airway ultrasound for patients predicted to have a difficult airway and who undergo cricothyroidotomy.
Core Tip: Airway ultrasound may provide a simpler and more accurate prediction of the difficult airway, especially to distinguish difficult mask ventilation from difficult tracheal intubation. Accurate cricothyroid membrane identification may provide a landmark for securing a surgical airway in clinical practice.
