The Effect of Ultrasonographic Airway Measurements and Anatomical Differences on Laryngeal Mask Placement in Young and Older Adults: A Prospective Observational Study

Laryngeal mask airway use is common in general anesthesia. Age-related anatomical and physiological changes of the upper airway may influence LMA placement in older adults. The study will prospectively evaluate patients undergoing procedures suitable for LMA placement at Düzce University Faculty of Medicine. Participants will be divided into young adults (18-40 years) and older adults (>65 years). Demographic, anthropometric, clinical airway assessment and ultrasonographic airway measurements will be recorded. Following standardized induction, a ProSeal LMA will be placed by an anesthesia research resident with at least three years of experience. The number of insertion attempts and placement time will be recorded. LMA position will be assessed by ultrasonography and compared with leak testing and fiberoptic confirmation. Ventilation parameters, cuff pressure, LMA position changes, gastric volume and postoperative complications will also be recorded.

Inclusion criteria

• Patient or legally appropriate representative/relative accepts participation as applicable.
• Surgery suitable for LMA placement.
• Age 18-40 years or >65 years.

Exclusion criteria

• Pregnancy
• Age <18 years
• History of upper airway surgery
• Gastroesophageal reflux disease, ulcer, or gastrointestinal bleeding history
• Inadequate fasting duration
• Emergency surgery
• Requirement for nasogastric tube placement
• Unstable teeth
• Mouth opening <3 cm
• Recent pulmonary infection
• Recent upper airway infection
• Pulmonary disease associated with increased airway pressures (cystic fibrosis, COPD, interstitial lung disease)
• Restricted cervical movement / inability to achieve required extension
• Ultrasound gel allergy
• Refusal to participate