Comparative Study Between Laryngeal Ultrasound and Cuff Leak Test in Predicting Post Extubation Airway Edema in Head and Neck Surgeries

Abstract

Background: Post-extubation complications like airway edema are among the leading causes of reintubation, extended mechanical ventilation, and higher patient morbidity. This study aims to lower the risk of these complications by comparing the effectiveness of Laryngeal Ultrasound and the Cuff Leak Test (CLT) in predicting airway edema post-extubation in patients undergoing head and neck surgeries.Methods: This prospective, case-control study involved 40 adult patients who underwent head and neck surgeries. Each patient was intubated for at least three hours. The study gathered detailed patient histories, including allergies, prior surgeries, and anesthetic complications, along with clinical parameters such as blood pressure and oxygen saturation.Results: Ultrasound measurements of the air column width difference (ACWD) were found to be more accurate (95%) than the cuff leak test (85%) in predicting airway edema. Ultrasound also had better specificity (94.7%) and a higher positive predictive value (PPV) (50%) compared to CLT (PPV of 25%).Conclusions: Laryngeal ultrasound is a non-invasive, reliable method for assessing vocal cords and laryngeal structure. Measuring the air column width via ultrasound may help identify patients at higher risk of airway edema, allowing more precautionary measures post-extubation.