الفهرس 
Chest UltrasoundOnly 14 pages are availabe for public view
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Abstract
Airway evaluation and management remains an ever emerging clinical science. Present airway management tools are static and don‘t provide dynamic airway management option.
In contrast, US provides point of care real time dynamic views of the airway in perioperative, emergency and critical care settings. It is free of ionizing radiation, portable, convenient, reproducible, accurate, easily mastered skill.
In view of the above, the present study was undertaken to investigate the role of US in the assessment of upper airways and determines whether US has the potential to serve as an effective, non-invasive method for diagnosis of tracheomalacia.
This prospective study was carried out on 53 consecutive patients admitted to the respiratory care units (RICU) of Ain Shams University Hospitals.
All patients were subjected to complete history taking, thorough clinical examination, chest x-ray, US examination of the airways and diaphragm together with either dynamic expiratory CT chest or Fibroptic bronchoscopy.
The results obtained were collected, tabulated and submitted for statistical analysis.The following results were obtained:
1. Prolonged mechanical ventilation was the most frequent risk factor for tracheomalacia as it was present in 29 patients with 54.7%.
2. Tracheomalacia was found more repeatedly among patients diagnosed with COPD exacerbation.
3. There wasn‘t significant correlation between difficult intubation and pretracheal soft tissue at the level of vocal cords as well as suprasternal notch.
4. The hyomental distance at a cutoff value <4.51 cm was considered to be a good predictor of difficult intubation with 100% sensitivity & 87.5% specificity.
5. US could successfully confirm ETT placement in 100% of cases where the tube was endotracheal in 30 cases (94%), while oesophageal in 2 cases (6%).
6. There was a strong positive correlation between subglottic airway diameter and ETT diameter.
7. Lateral pharyngeal wall thickness (LPW) was found to be a good predictor of obstructive sleep apnea, a new cut-off point was implemented at >4.1 cm in the intubated group of patients with 87.5% sensitivity and 95.8% specificity, while >4.2 cm in the non-intubated patients carried 100% sensitivity and 100% specificity.In the intubated group, out of the 7 cases diagnosed with tracheomalacia by FOB, 5 patients were missed by US with 40% sensitivity. While in the non-intubated group, only 1 case was missed with 90% sensitivity.