Short Neck, a New Criterion for Airway Assessment: A Pilot, Cross Sectional Single Blind Study
2020
Background: “Short Neck” is a term used by anesthesiologists and emergency physicians to describe one of the risk
factors of difficult airway management; but there is no consensus on what length constitutes short neck.
Study objective: To measure neck length and associate it with intubation difficulty in obese patients, the secondary
objective to find any relationship between short neck, difficult intubation and increasing body mass index.
Design: A pilot, cross sectional prospective single blinded study.
Sample: 97 adult patients scheduled for elective surgery, in Hamad General Hospital between March 2018 and
October 2018, under general anesthesia, was recruited for the study.
Results: Airway assessment using anthropometric measurements, including neck length, were documented prior to
anesthesia. Operators (anesthesiologists) were blinded. Intubation Difficult Scale was used. All data were documented
and analyzed afterwards. Patients were of three groups according to Intubation Difficulty Scale (IDS): Group A: IDS
0, Group B: IDS>0 - ≤ 5 and Group C: IDS>5. Five patients (5.2%) with intubation difficulty score>5 have a mean
neck length 7.6 cm. “Short Neck” was found to have a significant p value 0.022 within the three groups.
Conclusions: A patient's features relevant to airway assessment are rather difficult to quantify. This is the first
reported attempt to obtain an objective value for Short Neck in routine airway assessment.
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