Is obstructive sleep apnea associated with difficult airway? Evidence from a systematic review and meta-analysis of prospective and retrospective cohort studies.

For several years, OSA was known to be a risk factor of difficult airway. There are two interests in this meta-analysis. Firstly, the authors found that OSA had a three to four-fold higher risk of difficult intubation or mask ventilation or both, when compared to non-sleep apnea patients. Secondly, the authors found that there was no significant difference in the supraglottic airway failure rates in the sleep apnea vs non-sleep apnea patients. This is a very interesting information for the management of the upper airway in the operating room.