Despite the use of a variety of screening tests such as the Mallampati score inter incisor gap and thyromental distance the rate of difficult laryngoscopy and intubation remains 1.5 to 13 percent this highlights the uncertainty of traditional tests and the need for more dependable test parameters ultrasound has evolved as a simple non invasive portable and quick airway assessment technique it is well known for its regional block central venous catheterization and detecting pneumothorax in the operating room and intensive care units several studies have recently described its use in visualising airway structures 

Researchers have taken advantage of this advancement to obtain ultrasound guided measurement of parameter such as anterior commissure vocal cords and so on to the level of the skin the thyrohyoid membrane and hyoid bone are attached they attempted how these parameters can aid in the detection of a difficult airway 

The Anaesthesiologist primary responsibility is to ensure that the patient receives adequate ventilation. the airway is the most important component in this difficulties with optimal airway management can have serious consequences and failure can result in death we assessed the feasibility of sonography as an imaging tool for identifying important airway anatomical structures on the anterior aspect of the neck and correlated ultrasound guided measurement of airway parameter with Cormack Lehane classification of direct laryngoscopy for prediction of difficult airways in this study we will be predicting difficult laryngoscopy by ultrasound guided valuation of anterior neck soft tissue thickness