Utilization of submandibular ultrasound to measure oral cavity changes with interventions in routine airway management

Abstract

Ultrasound is a quick, noninvasive, inexpensive tool that can provide an accurate airway assessment. Tongue thickness, oral cavity height, and their relationship were measured using submandibular ultrasonography with and without oral airway interventions during intubation in 26 patients. The mean tongue thickness to oral cavity height ratio was 0.83 ± 0.03. The percent change of tongue thickness to oral cavity height decreased significantly by 36.47% with an oral airway and by 43.49% with laryngoscope interventions (P < 0.01). This study demonstrates how ultrasound-measured oral cavity ratios change with the placement of airway equipment, and application of these findings may advance our understanding of advanced airway management among diverse patient populations.

Keywords: Airway management; oral cavity; point-of-care ultrasound; submandibular sonography.

Figure 1.

Submandibular ultrasonography of the oral cavity. (a) Tongue thickness (TT) and oral cavity height (OCH) measurements in the awake patient. (b) Scan from an anesthetized patient with the oropharyngeal airway (arrow) in place. The concave nature of this device is clearly evident. (c) Sagittal scan from an anesthetized patient with a Miller laryngoscope in place (arrowhead). GH indicates geniohyoid muscle.