Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 10 12 36 42 Priya Nair Department of Anaesthesiology, Shri B.M.Patil Hospital(B.L.D.E.U), Vijayapura, Bharat, India. Sridevi Mulimani Department of Anaesthesiology, Shri B.M.Patil Hospital(B.L.D.E.U), Vijayapura, Bharat, India. Jyoti Mantur Department of Anaesthesiology, Shri B.M.Patil Hospital(B.L.D.E.U), Vijayapura, Bharat, India. Anusha Suntan Department of Anaesthesiology, Shri B.M.Patil Hospital(B.L.D.E.U), Vijayapura, Bharat, India. 2023 01 30 2023 03 25 Background: Unanticipated difficult intubation poses a challenge in routine practice for anaesthesiologists. A preoperative airway evaluation helps in the identification of a difficult airway. Airway assessment with ultrasound is a modality recently being used to predict difficult airway. In this study we evaluate ultrasonography parameters with conventional clinical parameters for predicting difficult airway in adults undergoing elective surgeries. Methods: This cross sectional randomised clinical trial analyses ASA class 1 and 2 adults requiring endotracheal intubation for surgeries under general anaesthesia were enrolled following which Modified Mallampatti score and thyromental distance as well as ultrasound distance to epiglottis (DSE) and distance to hyoid bone (DSHB) were measured and based on Cormack Lehane grading they were categorised into easy and difficult airway groups. Results: DSE had the highest sensitivity of 90.48% whereas Modified Mallampatti grading had least sensitivity of 66.67%. Conclusion: The results of this study showed that ultrasonographic measurements at the thyrohyoid and hyoid level have higher sensitivity and specificity than the clinical parameters for airway assessment. https://aacc.tums.ac.ir/index.php/aacc/article/view/708