Airway Ultrasound Prediction and Correlation

Study Overview
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Brief Summary
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This is a novel approach to assess the use of ultrasound to support the identification of obstructive sleep apnea syndrome (OSAS) on a screening questionnaire, and potentially to predict a difficult pediatric airway. The investigators hope to determine if a combination of simple bedside clinical tests can be used to identify OSAS in patients who present for surgery with clinical signs of OSAS but without a formal polysomnography.

Official Title
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Airway Ultrasound to Predict Obstructive Sleep Apnea Syndrome in Children and Its Correlation With Clinical Signs and Symptoms of Obstructive Sleep Apnea

Conditions
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Obstructive Sleep Apnea, Difficult Airway

Intervention / Treatment
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* Procedure: Ultrasound
* Other: Questionnaire


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All children presenting for surgery at NCH ranging in age from 3-12 years Exclusion Criteria: Parent/ patient refusal to participate in study

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 12 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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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Difficult Airway<br>Ultrasound to measure hyo-mental distance, neutral (Frankfort) position, maximal extended neck position to calculate ratio, width of the tongue between the lingual arteries, and tonsillar size (bilateral). | Procedure: Ultrasound<br>* Ultrasound to measure hyo-mental distance, neutral (Frankfort) position, maximal extended neck position to calculate ratio, width of the tongue between the lingual arteries, and tonsillar size (bilateral).<br>|
| Other: Obstructive Sleep Apnea<br>Ultrasound to measure hyo-mental distance, neutral (Frankfort) position, maximal extended neck position to calculate ratio, width of the tongue between the lingual arteries, and tonsillar size (bilateral). | Procedure: Ultrasound<br>* Ultrasound to measure hyo-mental distance, neutral (Frankfort) position, maximal extended neck position to calculate ratio, width of the tongue between the lingual arteries, and tonsillar size (bilateral).<br>|
| Other: Predictive Obstructive Sleep Apnea<br>The following 6 questions will be asked during the preoperative visit: While sleeping, does your child snore more than half the time? While sleeping, does your child always snore? Have you ever seen your child stop breathing during the night? Does your child occasionally wet the bed? Did your child stop growing at a normal rate at any time since birth? Is your child overweight | Other: Questionnaire<br>* The following 6 questions will be asked during the preoperative visit: While sleeping, does your child snore more than half the time? While sleeping, does your child always snore? Have you ever seen your child stop breathing during the night? Does your child occasionally wet the bed? Did your child stop growing at a normal rate at any time since birth? Is your child overweight<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hyo-mental distance | The distance from the hyoid bone to the mentum to predict difficult airway. | 5 minutes before surgery starts | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tongue width | Width of the tongue between the lingual arteries. | 5 minutes after being intubated in surgery | 
| Tonsil size | Size of tonsil (bilateral) | 5 minutes after being intubated in surgery | 
| Questionnaire | 6 predictive OSA questions | 30 minutes before surgery |