JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Ultrasonographic assessment of cricothyroid membrane height in a Turkish cohort
Abstract
Aims: Cricothyrotomy is a life-saving technique utilized in emergency airway management. This study aimed to assess the variability in the height of the cricothyroid membrane (CTM) based on gender, age, and body-mass index (BMI) across different neck positions, neutral and maximally extended.
Methods: The study enrolled healthy volunteers aged 18 years and older. Participant baseline characteristics (age, gender, and BMI) were systematically documented. The height of the CTM was measured using, with the participants’ necks positioned in neutral and extended postures. Associations between CTM height and demographic variables, including sex, age, height, and BMI, were evaluated.
Results: The study cohort comprised 296 individuals with a mean age of 41.84±15.76 years, ranging from 18 to 75 years. 30.3% of the participants were between 18 and 29 years old. 175 participants (59.1%) were female. The CTM height was significantly greater in the maximum extension position compared to the neutral position (p<0.001). CTM height in the neutral position was significantly lower in females compared to males (p<0.001). This difference persisted in the maximum extended position, where females also exhibited a lower CTM height than males (p<0.001).
Conclusion: The height of the CTM varies significantly based on gender and neck position. These variations have critical implications for performing cricothyrotomy, especially in the Turkish population, highlighting the need for tailored approaches in emergency procedures.

Keywords : Cricothyroid membrane, cricothyrotomy, ultrasound

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1. Lin J, Bellinger R, Shedd A, et al. Point-of-care ultrasound in airway evaluation and management: a comprehensive review. <em>Diagnostics (Basel).</em> 2023;13(9):1541. doi: 10.3390/diagnostics13091541
2. Katayama A, Watanabe K, Tokumine J, et al. Cricothyroidotomy needle length is associated with posterior tracheal wall injury: a randomized crossover simulation study (CONSORT). <em>Medicine (Baltimore)</em>. 2020;99(9):e19331. doi: 10.1097/MD. 0000000000019331
3. Alerhand, S. Ultrasound for identifying the cricothyroid membrane prior to the anticipated difficult airway. <em>Am J Emerg Med.</em> 2018;36:2078-2084.
4. Suzuki K, Yambe N, Hojo K, Komatsu Y, Serikawa M, Usami A. Anatomical morphometry for cricothyrotomy puncture and incision. <em>BMC Surg.</em> 2023;23(1):198. doi: 10.1186/s12893-023-02100-9
5. Athanassoglou V, Hughes-Jones H, Hadjipavlou G, Teoh WH, Kristensen MS, Vanner R. Depth to the airway lumen at the level of the cricothyroid membrane measured by ultrasound. <em>Acta Anaesthesiol Scand</em>. 2020;64(1):48-52. doi: 10.1111/aas.13464
6. Altun D, Ali A, Koltka K, et al. Role of ultrasonography in determining the cricothyroid membrane localization in the predicted difficult airway. <em>Ulus Travma Acil Cerrahi Derg.</em> 2019; 25:355-360.
7. Nutbeam T, Clarke R, Luff T, Enki D, Gay D. The height of the cricothyroid membrane on computed tomography scans in trauma patients. <em>Anaesthesia.</em> 2017;72(8):987-992. doi: 10.1111/anae.13905
8. Goto T, Kishimoto T, Sakurai S. The effectiveness of educational methods for cricothyroid membrane identification by dental students: a prospective study using neck photographs and tracheotomy trainers. <em>Clin Exp Dent Res.</em> 2019;5(2):170-177. doi: 10.1002/cre2.167
9. McCaul CL, Bick E, Vanner R. Equipment for cricothyroidotomy: optimum tube size needs a compatible bougie. <em>Comment on Br J Anaesth</em>. 2021;127:479-486. <em>Br J Anaesth</em>. 2021;127(6):e191-e192. doi: 10.1016/j.bja.2021.09.001
10. Osman A, Sum KM. Role of upper airway ultrasound in airway management. <em>J Intensive Care</em>. 2016;4:52. doi: 10.1186/s40560-016-0174-z
11. Weir CB, Jan A. BMI classification percentile and cut off points. [Updated 2020 Jul10].In StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK541070/ (StatPearls Publishing, 2020)
12. Kristensen MS, Teoh WH, Rudolph SS. Ultrasonographic identification of the cricothyroid membrane: best evidence, techniques, and clinical impact. <em>Br J Anaesth</em>. 2016;117(Suppl 1):i39-i48.
13. Kristensen MS, Teoh WH, Rudolph SS, Hesselfeldt R, Borglum J, Tvede MF. A randomised cross-over comparison of the transverse and longitudinal techniques for ultrasound-guided identification of the cricothyroid membrane in morbidly obese subjects<em>. Anaesthesia</em>. 2016; 71(6):675-683.
14. Kelly GS, Tekes-Brady A, Woltman NM. Anatomic characteristics of the adolescent cricothyroid membrane on computed tomography scans. <em>Pediatr Emerg Care</em>. 2022;38(9):e1533-e1537. doi: 10.1097/PEC.0000000000002622
15. Dover K, Howdieshell TR, Colborn GL. The dimensions and vascular anatomy of the cricothyroid membrane: relevance to emergent surgical airway access. <em>Clin Anat NYN.</em> 1996;9(5):291-295.
16. Wild E, You-Ten KE, Zasso F, Downey K, Ye XY, Siddiqui N. Impact of changing head and neck position on cricothyroid membrane localisation and height in third trimester parturients: an observational study. <em>Eur J Anaesthesiol</em>. 2022;39(6):566-568. doi: 10.1097/EJA.0000000000001564
17. .Prithishkumar IJ, David SS. Morphometric analysis and clinical application of the working dimensions of cricothyroid membrane in south Indian adults: with special relevance to surgical cricothyroidotomy. <em>Emerg Med Australas</em>. 2010;22(1):13-20.
18. Wong LY, Yang MLC, Leung HJ, Pak CS. Feasibility of sonographic access to the cricothyroid membrane in the presence of a rigid neck collar in healthy Chinese adults: a prospective cohort study. <em>Australas J Ultrasound Med</em>. 2019;23(2):121-128. doi: 10.1002/ajum.12187
19. Dixit A, Ramaswamy KK, Perera S, Sukumar V, Frerk C. Impact of change in head and neck position on ultrasound localisation of the cricothyroid membrane: an observational study. <em>Anaesthesia. </em>2019;74(1):29-32.
20. McCaul CL, Bick E, Vanner R. Equipment for cricothyroidotomy: optimum tube size needs a compatible bougie. <em>Comment on Br J Anaesth.</em> 2021;127:479-486. <em>Br J Anaesth</em>. 2021;127(6):e191-e192. doi: 10.1016/j.bja.2021.09.001
21. Oliveira KF, Arzola C, Ye XY, Clivatti J, Siddiqui N, You-Ten KE. Determining the amount of training needed for competency of anesthesia trainees in ultrasonographic identification of the cricothyroid membrane. <em>BMC Anesthesiol</em>. 2017;17(1):74. doi: 10.1186/s12871-017-0366-7
Article available in :
Volume 7, Issue 4, 2024
Page : 356-360
https://doi.org/10.32322/jhsm.1476093
Article Information
Received : 30 Nis 2024
Accepted : 25 May 2024
Published : 30 Tem 2024
Corresponding Author :

Doğa Özdemir Kalkan: Department of Radiology, Ankara Etlik City Hospital, Ankara, Turkiye

[email protected]
Citation : Özdemir Kalkan D, Kavak N. Ultrasonographic assessment of cricothyroid membrane height in a Turkish cohort. J Health Sci Med. 2024;7(4):356-360.

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