Anatomic features of the neck as predictive markers of difficult direct laryngoscopy in men and women: A prospective study.

studied patients with a BMI > 40 kg/m 2 and found that NC was a significant predictor of difficult intubation.[ 13 ] For a circumference of 40 cm, the probability of a difficult intubation was approximately 5%, while the probability increased up to 35% at a NC of 60 cm.[ 13 ] The odds increased by 1.13 times when NC increased by 1 cm.[ 13 ] Yet, it is not only the circumference but also the amount of pre-tracheal soft tissue that matters, as demonstrated in obese patients by the use of ultrasound.[ 30 ] Furthermore, gender-related anatomic differences may be significant; in our study, men had a significantly larger neck circumference than women, and similar findings have been reported by Brodsky et al .[ 13 ] Moreover, in our study, the predictive accuracy of NC was significantly improved in women when a different, gender-specific cut-off point was used.

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