Measurement of height of the cricothyroid membrane using cervical-spine computed tomography

¹Department of Emergency Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
²Department of Emergency Medicine, Bucheon St. Mary’s Hospital, Bucheon, Korea
³Department of Emergency Medicine, Yeouido St. Mary’s Hospital, Seoul, Korea

Correspondence

Seunghwan Seol ,Tel: 032-280-5042, Fax: 032-280-6382, Email: seunghwan.seol@gmail.com,

Received: February 9, 2021; Revised: May 24, 2021 Accepted: July 29, 2021. Published online: June 30, 2022.

ABSTRACT

Objective:
Emergency cricothyroidotomy is an infrequently performed procedure and post-procedural complications may result from attempting to pass a device with a large external diameter through the cricothyroid membrane. This study aimed to determine the maximum height of the cricothyroid membrane according to the patient’ s sex and age based on cervical-spine computed tomography (C-spine CT) in the emergency department (ED) and determine the appropriate endotracheal tube (ETT) size.
Method:
A retrospective analysis of patients was conducted from May 2014 to April 2020 in the ED. The data were obtained from medical records. Electronic calipers were used to measure the maximum height of the cricothyroid membrane in C-spine CT by an emergency physician and an emergency medicine resident.
Results:
Six hundred and sixty-four patients were included in the study. The mean height of the cricothyroid membrane was 10.11±2.24 mm in males (n=351) and 8.90±1.84 mm in females (n=313) (P<0.001). In males, the cricothyroid membrane height showed significant variance between the ≥75-year-old and the 25-34-year-old groups (9.26±2.40 mm vs. 11.80±2.36 mm) (P<0.001). The tube size of the cricothyroidotomy equipment was suitable for more than 72.1% of patients when applied with an ETT (internal diameter ≤6.0 mm).
Conclusion:
This study showed that the height of the cricothyroid membrane differed according to sex and also age in males. It may thus be necessary to consider anatomical differences according to sex and age when selecting the appropriate tube size to reduce complications during emergency cricothyroidotomy.

Key words: Airway management; Cricothyroid membrane; multi-detector computed tomography