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Obesity Surgery

, Volume 28, Issue 9, pp 2860–2867 | Cite as

Correlation of Neck Circumference with Difficult Mask Ventilation and Difficult Laryngoscopy in Morbidly Obese Patients: an Observational Study

  • Aylin Özdilek
  • Cigdem Akyol Beyoglu
  • Şafak Emre ErbabacanEmail author
  • Birsel Ekici
  • Fatiş Altındaş
  • Suphi Vehid
  • Güniz Meyancı Köksal
Original Contributions
  • 130 Downloads

Abstract

Purpose

Mask ventilation and laryngoscopy can be challenging in morbidly obese patients because of excessive fat tissue. There are studies suggesting that neck circumference is associated with difficult mask ventilation, difficult laryngoscopy, and difficult intubation. The primary aim of our study is to evaluate predictive value of neck circumference for difficult mask ventilation and difficult laryngoscopy in female and male morbidly obese patients separately.

Methods

This observational cross-sectional study was performed in the period between March 2015 and December 2015. One hundred and twenty (37 male and 83 female) patients undergoing elective surgery were included. Neck circumference, BMI, Mallampati scores, neck movements, dentition, upper lip bite test, breast, thorax, waist, hip circumferences, mouth opening, and sternomental and thyromental distances were evaluated preoperatively. Mask ventilation was graded using four-grade classification. Laryngoscopy was evaluated by Cormack Lehane score.

Results

The incidence of difficult mask ventilation was 13.5% in male and 3.6% in female patients. Mouth opening ≤ 6.5 cm and inadequate flexion were found as significant predictors for difficult mask ventilation in male patients. The incidence of difficult laryngoscopy was 10.8% in male and 4.8% in female patients. Mallampati score > II was found as a significant predictor for difficult laryngoscopy in both male and female patients. Sternomental distance ≤ 16 cm and inadequate flexion were also significant predictors for difficult laryngoscopy in male patients. Neck circumference was not found statistically significant predictor for difficult mask ventilation and laryngoscopy in morbidly obese patients in our study.

Conclusion

Neck circumference is not a statistically significant predictor for difficult mask ventilation and laryngoscopy in morbidly Turkish obese male and female patients.

Clinical Trials Registration Number

NCT02589015

Keywords

Morbid obesity Neck circumference Difficult mask ventilation Difficult laryngoscopy 

Notes

Acknowledgements

We would like to thank to Prof. Dr. Kağan Zengin for his assistance as the consulting surgeon.

Author Contributions

AÖ: Study design, literature review, patient recruitment, data collection, writing up the manuscript, and final approval of the version submitted.

ÇAB: Study design, literature review, patient recruitment, data collection, writing up the manuscript, and final approval of the version submitted.

EE: Study design, literature review, patient recruitment, data collection, writing up the manuscript, and final approval of the version submitted.

BE: Study design, literature review, writing up the manuscript, and final approval of the version submitted.

FA: Study design, literature review, data interpretation, revision of the manuscript for important intellectual content, and final approval of the version submitted.

SV: Study design, literature review, data collection, data analysis, writing up the manuscript, revision of the manuscript for important intellectual content, and final approval of the version submitted.

GMK: Study design, literature review, data interpretation, revision of the manuscript for important intellectual content, and final approval of the version submitted.

Funding Information

No funding was used.

Compliance with Ethical Standards

Conflict of Interests

The authors declare that there is no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Anesthesiology and ReanimationIstanbul University Cerrahpasa Medical FacultyIstanbulTurkey
  2. 2.Department of BiostatisticsIstanbul University Cerrahpasa Medical FacultyIstanbulTurkey

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