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There is growing interest in the role of point\u2010of\u2010care\u2010ultrasound in airway assessment and management. This systematic review and meta\u2010analysis aimed to determine the diagnostic utility and clinical application of various upper airway point\u2010of\u2010care\u2010ultrasound parameters in the prediction of difficult airways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched databases for randomised controlled trials, observational studies and case series with more than five cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 60 studies involving 10,580 patients, evaluating 58 parameters were included. For difficult facemask ventilation, a narrative synthesis showed that increased tongue thickness was associated with an increased incidence of a difficult airway. For prediction of difficult laryngoscopy, the sensitivity, specificity and area under the receiver operator characteristic curve (AUROC) for distance from\u2010skin\u2010to\u2010vocal\u2010cords were 0.84 (95%CI 0.74\u20130.91), 0.81 (95%CI 0.61\u20130.92) and 0.87 (95%CI 0.78\u20130.89), respectively (high certainty of evidence). For prediction of difficult tracheal intubation, distance from skin\u2010to\u2010epiglottis had the highest sensitivity (0.80 (95%CI 0.74\u20130.85)) and specificity (0.86 (95%CI 0.74\u20130.91)) (high certainty of evidence), while distance from skin\u2010to\u2010hyoid had the highest AUROC of 0.86 (95% CI 0.73\u20130.92), with a sensitivity and specificity of 0.78 (95%CI 0.60\u20130.89) and 0.81 (95%CI 0.63\u20130.91), respectively (moderate certainty of evidence). Ultrasound use was associated with higher first pass success in percutaneous tracheostomy (odds ratio (95%CI) 3.9 (2.1\u201371), (low\u2010moderate certainty of evidence)) and improved cricothyroid membrane identification compared with palpation (odds ratio (95%CI) 3.61 (2.20\u20135.92) (moderate\u2010high certainty of evidence)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Upper airway point\u2010of\u2010care ultrasound may improve prediction of difficult airways; its use is associated with improved first pass success in percutaneous tracheostomy. Future research should focus on evaluating its use in combination with a focused history and standard bedside examination tests, and in at\u2010risk patient populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.16751","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T09:57:47Z","timestamp":1756807067000},"page":"1556-1567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Point\u2010of\u2010care ultrasound of the upper airway in difficult airway management: a systematic review and meta\u2010analysis*"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2261-4495","authenticated-orcid":false,"given":"Vedish M.","family":"Soni","sequence":"first","affiliation":[{"name":"Heersink School of Biomedical Innovation McMaster University  Hamilton 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