Lengthening of the trachea during neck extension: which part of the trachea is stretched?

Anesthesia and Analgesia
David T WongJin Liu

Abstract

We sought to determine the distances of the three segments of the airway from upper incisors to carina in intubated patients in three different neck positions. Twenty patients undergoing elective surgery were studied. The airway was divided into three segments: upper incisor to vocal cords (UI-VC), vocal cords to sternal notch (VC-SN), and sternal notch to the carina (SN-CA). After general anesthesia and tracheal tube placement, the circuit was connected and the lungs ventilated. A bronchoscope was inserted through a ported elbow adapter until the tip just contacted carina. A marker tape was placed on the bronchoscope immediately above the adapter port. As the bronchoscope was withdrawn to the sternal notch (by transillumination), vocal cords and upper incisor (endoscopic visualization), three corresponding markers were placed along the bronchoscope. The three segments of the airway were obtained by measuring the distances between the four markers. Measurements were taken with the patient's neck in flexion (10 cm pillow), neutral (5 cm pillow), and extension (no pillow) positions. Repeated measure analysis of variance and paired t-tests were used for analysis of the data. The UI-VC, VC-SN, and SN-CA distances were 12.01 +/- 1.4...Continue Reading

References

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Citations

Apr 4, 2009·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·David T Wong, Hui Yun V Ip
Jul 29, 2009·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Kirollos Salah KamelMark D Stringer
Dec 18, 2018·The Journal of International Medical Research·Bora LeeHyun Joo Kim
Feb 3, 2019·Seminars in Cardiothoracic and Vascular Anesthesia·Megan D Henley, Priya A Kumar
Mar 8, 2017·Anaesthesia and Intensive Care·S T Herway, J L Benumof

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