Predicting the Difficult Airway: How Useful Are Preoperative Airway Tests?

Purpose of Review Available bedside predictors continue to have limitations in recognizing all patients with difficult airways. This review article aims to summarize the published literature from 2015 until 2021 regarding these predictors. Recent Findings In addition to traditionally described and recently proposed predictors, increasingly, technology such as ultrasound seems to improve accuracy of pre-airway management assessments. Summary Current best practice advocates for a comprehensive airway examination to identify predictors for difficult bagmask ventilation, supraglottic airway insertion, laryngoscopy and intubation, and front of neck access prior to airway instrumentation. This is crucial as the combination of the predictors improves the sensitivity and specificity in identifying the difficult airway. Adjunct tools such as ultrasound may be beneficial, especially in settings outside operating rooms where incidence of failed or difficult airway is higher. Predicted difficulty in any technique should prompt the airway expert to plan strategically prior to proceeding with airway instrumentation.