ArticleIndian journal of anaesthesia2026
Ultrasound-guided hyomental distance versus weight-based method for ProSeal LMA™ size selection: A randomised controlled study.
Article in Indian journal of anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aims: Conventional weight-based laryngeal mask airway (LMA) size selection does not consistently correlate with individual upper airway anatomy, leading to suboptimal device fit. Ultrasound-guided measurement of hyomental distance (HMD), an indicator of submandibular space, has emerged as a promising anatomy-based alternative. This study aimed to compare the efficacy and safety of ultrasound-guided HMD-based sizing with conventional weight-based sizing of the ProSeal LMA™ (Teleflex Inc., Wayne, PA, USA) (PLMA) in adult patients undergoing elective surgery. Methods: This prospective, double-blinded randomised controlled trial included 116 American Society of Anesthesiologists (ASA) physical status I-II adults aged 18-60 years scheduled for elective surgery under general anaesthesia. Patients were randomised into two groups: Group A underwent PLMA size selection based on body weight, while Group B underwent ultrasound-guided HMD-based size selection. The primary outcome was first-attempt insertion success. Secondary outcomes included insertion time, number of attempts, need for reinsertion, and postoperative oral injury. Results: Demographic characteristics were comparable between groups. First-attempt insertion success was similar in both groups (93.1% in weight-based group vs. 96.6% in HMD group; Conclusion: Ultrasound-guided HMD-based PLMA sizing provides an individualised, anatomy-based alternative to weight-based selection, achieving comparable insertion success, efficiency, and safety while favouring anatomically appropriate device sizing.
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