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Preoperative point-of-care neck ultrasound: beyond the airway

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Abstract

Purpose

A preoperative point-of-care neck ultrasound, carried out during preoperative airway evaluation by extending the scans to the regions close to the larynx and trachea, can allow for the rapid identification of unknown pathologies or abnormalities in a cost-effective and non-invasive manner. This prospective, observational study examines a series of ultrasound findings in structures close to the airway, made through preoperative point-of-care neck ultrasound in a cohort of 230 patients.

Methods

We conducted a prospective observational study, enrolling 230 adult patients selected for elective abdominal surgery. The primary goal was to verify the predictive role of airway ultrasound in identifying difficult airways, while the secondary goal was to evaluate structures close to the airway such as jugular veins, carotid arteries, thyroid gland and soft tissues.

Results

Overall, preoperative point-of-care neck ultrasound proved to be an effective and reliable method of obtaining details about local or systemic pathologies, which could affect perioperative care. For example, the exam consistently revealed the presence of carotid plaques or venous congestion, which could be used to best determine the patient’s cardiovascular risk or to instigate further investigations. It also allowed for more accurate central venous catheter placement planning and better airway management and it warned about possible thyroid or neoplastic pathologies that would have otherwise remained unknown. In some cases, information from preoperative point-of-care neck ultrasound has even led to modifications in perioperative therapy.

Conclusion

Preoperative point-of-care neck ultrasound is fast, inexpensive, and non-invasive, and it can be easily performed by a properly trained professional during the preoperative airway ultrasound evaluation. It can be considered as a new preoperative assessment tool.

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Data availability

The data that support the findings of this study are available from the corresponding author, Filippo Susi, upon reasonable request.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Post-Surgical and Transplant Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

    Amedeo Bianchini, Cristiana Laici & Antonio Siniscalchi

  2. Department of Medical and Surgical Sciences (DIMEC), Università di Bologna, Bologna, Italy

    Filippo Susi & Benedetta Gollinucci

  3. Anesthesia and Pain Therapy Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

    Elena Zangheri

Authors
  1. Amedeo Bianchini
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  2. Filippo Susi
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  3. Cristiana Laici
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  4. Elena Zangheri
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  5. Benedetta Gollinucci
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  6. Antonio Siniscalchi
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Contributions

All authors contributed to the study conception and design.

Corresponding author

Correspondence to Filippo Susi.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

These data are ancillary to an observational study carried out by our group (Ethical approval N. 58/2017/O/Sper Protocol VAD). Written informed consent was obtained from all the patients, including the possibility of image publication in an anonymous form.

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Bianchini, A., Susi, F., Laici, C. et al. Preoperative point-of-care neck ultrasound: beyond the airway. J Ultrasound 27, 185–190 (2024). https://doi.org/10.1007/s40477-023-00840-1

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  • DOI: https://doi.org/10.1007/s40477-023-00840-1

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