Evidence map›Paper›PMID 41718106›Full record

ArticleMedical sciences (Basel, Switzerland)2026

Predicting Difficult Tracheal Intubation in Head and Neck Cancer Patients with Osteoradionecrosis: Development of the ORN-Difficult-Airway-Score.

Davut Deniz Uzun, Tobias Gruebl, Moritz Bleymehl, Oliver Ristow, Fabian Weykamp, Thomas Held, Stefan Mohr, Felix C F Schmitt, Markus A Weigand, Juergen Debus and 1 more

Abstract read
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In one paragraph

Article in Medical sciences (Basel, Switzerland), 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

11 authors.

Davut Deniz UzunDepartment of Anesthesiology, Medical Faculty Heidelberg, University Heidelberg, 69120 Heidelberg, Germany.ORCID 0000-0002-0559-8684
Tobias GrueblDepartment of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Philipps University of Marburg, 35043 Marburg, Germany.ORCID 0000-0003-2621-961X
Moritz BleymehlDepartment of Oral and Cranio-Maxillofacial Surgery, Medical Faculty Heidelberg, University Heidelberg, 69120 Heidelberg, Germany.
Oliver RistowDepartment of Oral and Cranio-Maxillofacial Surgery, Medical Faculty Heidelberg, University Heidelberg, 69120 Heidelberg, Germany.
Fabian WeykampDepartment of Radiation Oncology, Medical Faculty Heidelberg, University Heidelberg, 69120 Heidelberg, Germany.ORCID 0000-0003-1731-7090
Thomas HeldDepartment of Radiation Oncology, Medical Faculty Heidelberg, University Heidelberg, 69120 Heidelberg, Germany.ORCID 0000-0002-3913-4693
Stefan MohrDepartment of Anesthesiology, Medical Faculty Heidelberg, University Heidelberg, 69120 Heidelberg, Germany.ORCID 0000-0003-4292-663X
Felix C F SchmittDepartment of Anesthesiology, Medical Faculty Heidelberg, University Heidelberg, 69120 Heidelberg, Germany.ORCID 0000-0001-6464-6191
Markus A WeigandDepartment of Anesthesiology, Medical Faculty Heidelberg, University Heidelberg, 69120 Heidelberg, Germany.
Juergen DebusDepartment of Radiation Oncology, Medical Faculty Heidelberg, University Heidelberg, 69120 Heidelberg, Germany.ORCID 0000-0002-6411-4811
Kristin Uzun-LangDepartment of Radiation Oncology, Medical Faculty Heidelberg, University Heidelberg, 69120 Heidelberg, Germany.ORCID 0000-0002-5355-3173

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOsteoradionecrosis (ORN) following head and neck radiotherapy has been demonstrated to induce structural and functional alterations of the upper airway, with the potential to complicate the process of tracheal intubation. Despite its clinical relevance, there is a paucity of systematic evidence on airway characteristics in ORN and reliable predictors of difficult tracheal intubation. This study compares preoperative airway parameters and tracheal intubation outcomes in irradiated patients with and without ORN and introduces a novel preoperative ORN-Difficult-Airway Score for risk stratification.

methodsIn this retrospective cohort study, airway assessments, tracheal intubation methods, and perioperative visualization parameters were evaluated in 105 patients following head and neck radiotherapy. Group differences between non-ORN and ORN were analyzed using chi-square tests. A preoperative ORN-Difficult-Airway Score was constructed using exclusively bedside parameters, based on statistically and clinically relevant predictors.

resultsPatients with ORN showed significantly restricted mouth opening (

conclusionsORN has been associated with distinct alterations in airway anatomy and visualization, resulting in increased tracheal intubation complexity after head and neck radiotherapy. The proposed ORN-Difficult-Airway Score presents a clinically practical, bedside-applicable approach to stratifying the risk of tracheal intubation in this population. Prior to clinical implementation, prospective validation in larger cohorts is warranted.

Indexed as

Head and Neck NeoplasmsIntubation, IntratrachealOsteoradionecrosisAdultAgedFemaleHumansLaryngoscopyMaleMiddle AgedRetrospective Studiesairway assessmentdifficult airwayfiberoptic intubationhead and neck cancerosteoradionecrosisprediction scoreradiotherapyvideolaryngoscopy

Identifiers

PMID41718106
PMCPMC12921790

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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.