Morphometric analysis and clinical application of the working dimensions of cricothyroid membrane in south Indian adults: With special relevance to surgical cricothyroidotomy

Prithishkumar, Ivan James; David, Suresh S.

doi:10.1111/j.1742-6723.2009.01245.x

Cited by 19 publications

(13 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…15,16 Characteristics and anatomic measurements of the subjects were as follows: Subject 1, non-obese female with a small neck circumference; Subject 2, morbidly obese female with a large neck circumference and significant pre-tracheal subcutaneous tissue; Subject 3, tall female with a small neck circumference; and Subject 4, non-obese female with the lowest TMD/SMD ratio of the four subjects. Subjects were positioned in a standardized fashion with the neck optimally extended (as the height of the CTM increases upon neck extension, 20 exposing a larger working area to perform a cricothyrotomy. Table 2 represents participant characteristics of the anesthesia providers and surgeons.…”

Section: Methodsmentioning

confidence: 99%

Comparing success rates of anesthesia providers versus trauma surgeons in their use of palpation to identify the cricothyroid membrane in female subjects: a prospective observational study

Hiller

Karni

Cai

et al. 2016

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Section: Methodsmentioning

confidence: 99%

Comparing success rates of anesthesia providers versus trauma surgeons in their use of palpation to identify the cricothyroid membrane in female subjects: a prospective observational study

Hiller

Karni

Cai

et al. 2016

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

“…Cadaver studies that examined location and movement of the cricothyroid membrane have been published [6][7][8][9] but a PubMed search using key words 'identification' and 'cricothyroid membrane' for the time period 1999-2017 did not identify any studies that assessed the location of the CTM with change in head and neck position in living people, nor any studies which indicated that change in position of head and neck had any effect on the height of the CTM. We were, therefore, unable to perform an a priori power analysis to determine an appropriate sample size to evaluate our two hypotheses using tests of statistical significance, so we designed an observational pilot study to help us decide whether our hypotheses were worthy of further investigation.…”

Section: Introductionmentioning

confidence: 99%

“…The primary aim of the study was to assess whether a Previous ultrasound studies of the CTM in cadavers [8,9] used 23, 24 or 25 cadavers per group and showed good homogeneity within groups, so we planned to recruit 25 volunteers for our study. (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Impact of change in head and neck position on ultrasound localisation of the cricothyroid membrane: an observational study

et al. 2018

View full text Add to dashboard Cite

The ideal position for performing surgical cricothyroidotomy is with full neck extension. Some authors have recommended marking the cricothyroid membrane before general anaesthesia, typically with the patient's head and neck in a neutral position. The primary aim of this observational study was to determine whether skin marks made over the centre of the cricothyroid membrane with the head and neck in the neutral position moved outside the boundaries of the membrane when the neck was subsequently extended. The secondary aim was to assess changes in the height of the cricothyroid membrane between the neutral and extended positions. Twenty-two volunteers completed the study. With the head and neck in the neutral position, the distance between the upper and lower borders ('height') of the cricothyroid membrane was measured by a radiologist using ultrasound. The skin was marked over the mid-point of the membrane. The subject then maximally extended the neck, and the measurements and marking were repeated. The skin marking over the centre point of the cricothyroid membrane moved by median (IQR [range]) 5 (4-6 [0-10]) mm when the head and neck were moved from a neutral to a fully extended position. The initial skin mark moved to lie outside the boundary of the cricothyroid membrane in 12 of 22 subjects after extending the neck. The height of the cricothyroid membrane increased by 30% with the neck extended. We recommend that marking the skin in preparation for cricothyroidotomy should be performed with the neck extended, not with the head and neck in the neutral position as previously suggested.

show abstract

“…The size of the cricothyroid membrane in the western population is reported as 7.5 mm–10.5 mm in female cadavers and 10.0 mm–13.0 mm in male cadavers . A study examining the south Indian population found the cricothyroid membrane to be much smaller, at 3.0 mm–8.4 mm in female and 3.0 mm–10.0 mm in male cadavers . The same study reported that the height of the cricothyroid membrane should be used to judge appropriate tracheal tube size for emergency cricothyotomy; the external diameter of the tracheal tube should be smaller than the height of the cricothyroid membrane measured in the neutral position.…”

Section: Introductionmentioning

confidence: 99%

The height of the cricothyroid membrane on computed tomography scans in trauma patients

et al. 2017

View full text Add to dashboard Cite

SummaryEmergency cricothyrotomy is a common feature in all difficult airway algorithms. It is the final step following a 'can't intubate, can't oxygenate' scenario. It is rarely performed and has a significant failure rate. There is variation in the reported size of the cricothyroid membrane, especially across population groups. Procedural failure may result from attempting to pass a device with too large an external diameter through the cricothyroid membrane. We aimed to determine the maximum height of the cricothyroid membrane in a UK trauma population. Electronic callipers were used to measure the maximum height of the cricothyroid membrane on 482 reformatted trauma computed tomography scans, 377 (78.2%) of which were in male patients. The mean (SD) height of the cricothyroid membrane, as independently measured by two radiologists, was 7.89 (2.21) mm and 7.88 (2.22) mm in male patients, and 6.00 (1.76) mm and 5.92 (1.71) mm in female patients. The presence of concurrent tracheal intubation or cervical spine immobilisation was found not to have a significant effect on cricothyroid membrane height. The cricothyroid membrane height in the study population was much smaller than that previously reported. Practitioners encountering patients who may require an emergency surgical airway should be aware of these data. Rescue airway equipment with variety of external diameters should be immediately available.

show abstract

Morphometric analysis and clinical application of the working dimensions of cricothyroid membrane in south Indian adults: With special relevance to surgical cricothyroidotomy

Abstract: Working dimensions are smaller in the Indian group compared with western publications. Endotracheal tubes ranging from size 3.0 to 6.0 might be used for cricothyroidotomy in the adult south Indian population.

Cited by 19 publications

References 8 publications

Comparing success rates of anesthesia providers versus trauma surgeons in their use of palpation to identify the cricothyroid membrane in female subjects: a prospective observational study

Comparing success rates of anesthesia providers versus trauma surgeons in their use of palpation to identify the cricothyroid membrane in female subjects: a prospective observational study

Impact of change in head and neck position on ultrasound localisation of the cricothyroid membrane: an observational study

The height of the cricothyroid membrane on computed tomography scans in trauma patients

Contact Info

Product

Resources

About