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Ultrasound: A novel tool for airway imaging.

Parmar SB, Mehta HK, Shah NK, Parikh SN, Solanki KG - J Emerg Trauma Shock (2014)

Bottom Line: We included 100 adult, healthy volunteers of either sex to undergo airway imaging systemically starting from floor of the mouth to the sternal notch in anterior aspect of neck by sonography.Interface between air and mucosa lining the airway produced a bright hyperechoic linear appearance.Artifacts created by intraluminal air prevented visualization of posterior pharynx, posterior commissure, and posterior wall of trachea.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, Byramjee Jeejeebhoy Medical College, Ahmedabad, Gujarat, India.

ABSTRACT

Context: The scope of ultrasound is emerging in medical science, particularly outside traditional areas of radiology practice.

Aims: We designed this study to evaluate feasibility of bedside sonography as a tool for airway assessment and to describe sonographic anatomy of airway.

Settings and design: A prospective, clinical study.

Materials and methods: We included 100 adult, healthy volunteers of either sex to undergo airway imaging systemically starting from floor of the mouth to the sternal notch in anterior aspect of neck by sonography.

Results: We could visualize mandible and hyoid bone as a bright hyperechoic structure with hypoechoic acoustic shadow underneath. Epiglottis, thyroid cartilage, cricoid cartilage, and tracheal rings appeared hypoechoic. Vocal cords were visualized through thyroid cartilage. Interface between air and mucosa lining the airway produced a bright hyperechoic linear appearance. Artifacts created by intraluminal air prevented visualization of posterior pharynx, posterior commissure, and posterior wall of trachea.

Conclusions: Ultrasound is safe, quick, noninvasive, repeatable, and bedside tool to assess the airway and can provide real-time dynamic images relevant for several aspects of airway management.

No MeSH data available.


Related in: MedlinePlus

Transverse view at the level of suprasternal notch using a linear transducer in left lateral side. The scan shows trachea (Tr), esophagus (Oeso), thyroid gland (ThG), strap muscles (SM), carotid artery (CA), vertebral body of cervical vertebra (VB), and sternocleidomastoid muscle (SCM)
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Figure 12: Transverse view at the level of suprasternal notch using a linear transducer in left lateral side. The scan shows trachea (Tr), esophagus (Oeso), thyroid gland (ThG), strap muscles (SM), carotid artery (CA), vertebral body of cervical vertebra (VB), and sternocleidomastoid muscle (SCM)

Mentions: Trachea, thyroid gland, and esophagus could be visualized in transverse view at the level of suprasternal notch [Figures 11 and 12]. Tracheal rings appeared hypoechoic structures in sonography. On transverse view, they appeared as an inverted U-shaped hypoechoic structure, delineated posteriorly by a linear hyperechoic air-mucosal interface and reverberation artifact. They looked like ‘strings of beads’ in parasagittal view [Figure 9]. Thyroid gland was very well-visualized just anterolateral to trachea as homogenous and hyperechoic, compared to adjacent soft tissues. Esophagus lay posterolateral to trachea and could be distinguish from trachea by peristaltic movement of esophageal lumen during swallowing in real-time sonography.[89]


Ultrasound: A novel tool for airway imaging.

Parmar SB, Mehta HK, Shah NK, Parikh SN, Solanki KG - J Emerg Trauma Shock (2014)

Transverse view at the level of suprasternal notch using a linear transducer in left lateral side. The scan shows trachea (Tr), esophagus (Oeso), thyroid gland (ThG), strap muscles (SM), carotid artery (CA), vertebral body of cervical vertebra (VB), and sternocleidomastoid muscle (SCM)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126113&req=5

Figure 12: Transverse view at the level of suprasternal notch using a linear transducer in left lateral side. The scan shows trachea (Tr), esophagus (Oeso), thyroid gland (ThG), strap muscles (SM), carotid artery (CA), vertebral body of cervical vertebra (VB), and sternocleidomastoid muscle (SCM)
Mentions: Trachea, thyroid gland, and esophagus could be visualized in transverse view at the level of suprasternal notch [Figures 11 and 12]. Tracheal rings appeared hypoechoic structures in sonography. On transverse view, they appeared as an inverted U-shaped hypoechoic structure, delineated posteriorly by a linear hyperechoic air-mucosal interface and reverberation artifact. They looked like ‘strings of beads’ in parasagittal view [Figure 9]. Thyroid gland was very well-visualized just anterolateral to trachea as homogenous and hyperechoic, compared to adjacent soft tissues. Esophagus lay posterolateral to trachea and could be distinguish from trachea by peristaltic movement of esophageal lumen during swallowing in real-time sonography.[89]

Bottom Line: We included 100 adult, healthy volunteers of either sex to undergo airway imaging systemically starting from floor of the mouth to the sternal notch in anterior aspect of neck by sonography.Interface between air and mucosa lining the airway produced a bright hyperechoic linear appearance.Artifacts created by intraluminal air prevented visualization of posterior pharynx, posterior commissure, and posterior wall of trachea.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, Byramjee Jeejeebhoy Medical College, Ahmedabad, Gujarat, India.

ABSTRACT

Context: The scope of ultrasound is emerging in medical science, particularly outside traditional areas of radiology practice.

Aims: We designed this study to evaluate feasibility of bedside sonography as a tool for airway assessment and to describe sonographic anatomy of airway.

Settings and design: A prospective, clinical study.

Materials and methods: We included 100 adult, healthy volunteers of either sex to undergo airway imaging systemically starting from floor of the mouth to the sternal notch in anterior aspect of neck by sonography.

Results: We could visualize mandible and hyoid bone as a bright hyperechoic structure with hypoechoic acoustic shadow underneath. Epiglottis, thyroid cartilage, cricoid cartilage, and tracheal rings appeared hypoechoic. Vocal cords were visualized through thyroid cartilage. Interface between air and mucosa lining the airway produced a bright hyperechoic linear appearance. Artifacts created by intraluminal air prevented visualization of posterior pharynx, posterior commissure, and posterior wall of trachea.

Conclusions: Ultrasound is safe, quick, noninvasive, repeatable, and bedside tool to assess the airway and can provide real-time dynamic images relevant for several aspects of airway management.

No MeSH data available.


Related in: MedlinePlus