Pre‐operative three‐dimensional face scans for predicting difficult facemask ventilation: a prospective development study
Authors' conclusion
Pre-operative three-dimensional face scans predicted difficult facemask ventilation at least as well as the DIFFMASK score. Integrating the features of three selected facial shapes enriched the DIFFMASK score and improved its diagnostic value.
Study context
- Population
- Patients undergoing ear, nose and throat or maxillofacial surgery with pre-operative 3D face scansanalysed
- Participants
- 398 patients
- Comparison
- DIFFMASK score vs facial shape features vs DIFFMASK enriched with 3 facial shape features
- Outcome
- Difficult facemask ventilation documented as an alert in the patient health record
Methodological detailsprospective, observational, single-centre, development study
- Prospective
- Observational
- Single-centre
- Development study
Performance
As reported in the abstract
Prediction of difficult facemask ventilation
| Test or model | Optimism-corrected AUC | 95% CI |
|---|---|---|
| DIFFMASK score | 0.73 | 0.65-0.80 |
| Facial shape features | 0.74 | 0.66-0.82 |
| DIFFMASK + 3 facial shape features | 0.76 | 0.68-0.82 |
Optimism-corrected AUC
DIFFMASK score0.73
Facial shape features0.74
DIFFMASK + 3 facial shape features0.76
95% CI
DIFFMASK score0.65-0.80
Facial shape features0.66-0.82
DIFFMASK + 3 facial shape features0.68-0.82
- DIFFMASK + 3 facial shape features vs DIFFMASK score: P = 0.002 — improved
Further findings
- Morphological features of the nose, lower mandible, neck region and facial convexity most predictive of difficult facemask ventilation
Original publication
Pre‐operative three‐dimensional face scans for predicting difficult facemask ventilation: a prospective development study. Anaesthesia. Published 5 June 2026. doi:10.
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