Evidence map›Paper›PMID 40567199›Full record

Observational studyKorean journal of anesthesiology2026

Accuracy of ultrasound-measured skin-to-hyoid bone distance for predicting difficult mask ventilation in patients with obesity: a prospective observational study.

Maha Mostafa, Israa ElGeneidi, Ahmed Hasanin, Mostafa Ali, Hanan Mostafa, Nader Noshy Naguib

Abstract readObservational Study
In one paragraph

Observational study in Korean journal of anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Maha MostafaDepartment of Anesthesia and Critical Care Medicine, Cairo University Faculty of Medicine, Cairo, Egypt. maha.mostafa@cu.edu.eg.
Israa ElGeneidiDepartment of Anesthesia and Critical Care Medicine, Cairo University Faculty of Medicine, Cairo, Egypt.
Ahmed HasaninDepartment of Anesthesia and Critical Care Medicine, Cairo University Faculty of Medicine, Cairo, Egypt.
Mostafa AliDepartment of Anesthesia and Critical Care Medicine, Cairo University Faculty of Medicine, Cairo, Egypt.
Hanan MostafaDepartment of Anesthesia and Critical Care Medicine, Cairo University Faculty of Medicine, Cairo, Egypt.
Nader Noshy NaguibDepartment of Anesthesia and Critical Care Medicine, Cairo University Faculty of Medicine, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe risk of difficult mask ventilation (DMV) is high in patients with obesity. Therefore, we evaluated the accuracy of ultrasound-measured skin-to-hyoid bone distance (SHD) for predicting DMV in this population.

methodsThis prospective observational study included adult patients with obesity scheduled for elective surgery. Preoperative airway assessment included the modified Mallampati test, thyromental distance, sternomental distance, upper lip bite test, mouth opening, neck mobility, STOP-Bang score, and the SHD measured by a handheld ultrasound probe. The mask ventilation grade was evaluated using the 4-level Han score, and grades 3 and 4 were considered as DMV. The primary outcome was the ability of SHD to predict DMV using area under the receiver operating characteristic curve (AUC) analysis. A multivariate model including the STOP-Bang score, modified Mallampati test, upper lip bite test, and SHD was also assessed.

resultsData from 326 patients were analyzed. The DMV incidence was 22/326 (6.7%). Patients with DMV were predominantly male and had higher weight, STOP-Bang score, modified Mallampati grade, upper lip bite class, and SHD than did those with easy mask ventilation. The AUC (95% CI) of the SHD for predicting DMV was 0.88 (0.84-0.92). An SHD > 1.9 cm had a positive-predictive value of 27%, while its negative-predictive value was 99% (for SHD ≤ 1.9 cm). Multivariate analysis revealed that the SHD was an independent predictor of DMV.

conclusionsIn patients with obesity, SHD measured by a handheld ultrasound probe is an independent predictor of DMV and can accurately predict DMV. An SHD ≤ 1.9 cm can exclude DMV with 99% accuracy.

Indexed as

Airway ManagementHyoid BoneLaryngeal MasksObesityRespiration, ArtificialSkinAdultAgedFemaleHumansMaleMiddle AgedPredictive Value of TestsProspective StudiesUltrasonographyAirway managementObesityPoint-of-care systemsPredictive value of testsUltrasonographyVentilation.

Identifiers

PMID40567199
PMCPMC13244167

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.