Predictive Parameters for Difficult Tracheal Intubation Identification in Thyroid Surgery

Study Overview
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Brief Summary
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Intubation manoeuvres in patients undergoing thyroid surgery might be challenging for anesthesiologist. Thyroid gland enlargement (goiter) or tissue fibrosis (neoplasms) could alter the physiologic anatomy of upper airways and trachea, resulting in compression or dislocation. We want to evaluate the incidence and identify predictive parameters of difficult intubation in patients undergoing thyroid surgery.

Detailed Description
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Intubation manoeuvres in patients undergoing thyroid surgery might be challenging for anesthesiologist. Thyroid gland enlargement (goiter) or tissue fibrosis (neoplasms) could alter the physiologic anatomy of upper airways and trachea, resulting in compression or dislocation. There are few scientific data about airway management and thyroid pathology and the incidence of difficult tracheal intubation in this specific kind of patient is largely variable from 0% to 12.9%. These data have been collected from little statistical samples (from 50 to 326 patients), the results aren't always unanimous and a study evaluating simultaneously all the risk factors for difficult intubation does not exist. We want to evaluate the incidence and identify predictive parameters of difficult intubation in patients undergoing thyroid surgery. During pre-anesthetic assessment the following data will be collected: Inter-incisor gap (cm) Mallampati test (1;2;3;4) Thyromental distance (cm) Prognathism (yes; no) Neck motility (<80°;80-90°;>90°) Total body weight (kg) History of difficult tracheal intubation (yes; no) Tracheal deviation at chest X-Ray (yes; no) Neck circumference (cm) Mediastinal goiter (yes; no) Histologic features (benign; carcinoma) During the post-anesthesia it will be noted down the following: Cormack scale (1; 2a; 2b; 3; 4) Number of necessary attempts to intubate (1;2;3;…) Time from induction to intubation (min) Necessity to use advanced airway management devices (Frova; Glidescope; Ambu-scope; fiber-optic; other)

Official Title
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Predictive Parameters for Difficult Tracheal Intubation Identification in Thyroid Surgery, a Observational Monocentric Prospective Study

Conditions
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Intubation;Difficult

Intervention / Treatment
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* Other: Thyroid surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: thyroid surgery Exclusion Criteria: <18 years

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Thyroid surgery<br>Patient undergoing thyroid surgery | Other: Thyroid surgery<br>* Patient undergoing thyroid surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Difficult intubation incidence | Difficult intubation described as Cormack 3 or 4 | through study completion, an average of 2 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Histologic features (benign; carcinoma) as predictive parameter for difficult intubation | preoperative Histologic features (benign; carcinoma) as predictive parameter for difficult intubation | through study completion, an average of 2 year | 
| Neck circumference (cm) as predictive parameter for difficult intubation | preoperative Neck circumference (cm) as predictive parameter for difficult intubation | through study completion, an average of 2 year | 
| Tracheal deviation at chest X-Ray (yes; no) as predictive parameter for difficult intubation | preoperative Tracheal deviation at chest X-Ray (yes; no) as predictive parameter for difficult intubation | through study completion, an average of 2 year | 
| History of difficult tracheal intubation (yes; no) as predictive parameter for difficult intubation | preoperative History of difficult tracheal intubation (yes; no) as predictive parameter for difficult intubation | through study completion, an average of 2 year | 
| Total body weight (kg) as predictive parameter for difficult intubation | preoperative Total body weight (kg) as predictive parameter for difficult intubation | through study completion, an average of 2 year | 
| Neck motility (<80°;80-90°;>90°) as predictive parameter for difficult intubation | preoperative Neck motility (<80°;80-90°;>90°) as predictive parameter for difficult intubation | through study completion, an average of 2 year | 
| Thyromental distance (cm) as predictive parameter for difficult intubation | preoperative Thyromental distance (cm) as predictive parameter for difficult intubation | through study completion, an average of 2 year | 
| Mediastinal goiter (yes; no) as predictive parameter for difficult intubation | preoperative Mediastinal goiter (yes; no) as predictive parameter for difficult intubation | through study completion, an average of 2 year | 
| Prognathism (yes; no) as predictive parameter for difficult intubation | preoperative Prognathism (yes; no) as predictive parameter for difficult intubation | through study completion, an average of 2 year | 
| Mallampati test (1;2;3;4) as predictive parameter for difficult intubation | preoperative Mallampati test (1;2;3;4) as predictive parameter for difficult intubation | through study completion, an average of 2 year | 
| Inter-incisor gap (cm) as predictive parameter for difficult intubation | preoperative Inter-incisor gap (cm) as predictive parameter for difficult intubation | through study completion, an average of 2 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Difficult, Intubation, thyroid