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Peter Fabian - One of the best experts on this subject based on the ideXlab platform.

  • dimensions of the Cricoid Cartilage and the trachea
    Laryngoscope, 2000
    Co-Authors: Ake Randestad, Carleric Lindholm, Peter Fabian
    Abstract:

    OBJECTIVE Important dimensions of the Cricoid Cartilage and trachea have been studied. Knowledge of size, variations in size, and configuration of these structures is important when tracheal intubation, stenting, endoscopy, and transplantation are to be performed. METHODS In 34 male and 27 female adult human specimens, 1,861 measurements of the Cricoid Cartilage and trachea were performed. RESULTS The smallest dimension was found in the frontal plane. The mean inner diameter of the Cricoid in this plane with mucous membrane in situ was in women 11.6 mm (range, 8.9-17.0 mm) and in men 15.0 mm (range, 11.0-21.5 mm). The configuration varied more than expected. For example, the angle between the longitudinal axes of the cricoarytenoid joint facets ranged from 42 degrees to 74 degrees in women and from 37 degrees to 75 degrees in men. The mean distance between these joint facets was 10.3 mm (range, 7.4-13.0 mm) in women and 12.6 mm (range, 8.0-18.2 mm) in men. The cross-section of the trachea varied much in configuration, the smallest frontal diameter being as little as 9.9 mm in women and 12 mm in men. CONCLUSIONS In some women the inner diameter of the Cricoid ring does not permit passage of a standard-size (7 mm, internal diameter [ID]) tracheal tube or a standard-size rigid endoscope through the larynx without mucosal damage. The small distance between the cricoarytenoid joints in many women and some men is the basis for of the clinical observation that women, especially, receive pressure necroses at the medial sides of the arytenoid Cartilages attributable to tracheal intubation with standard tubes. The large difference in almost all sizes and shapes of the Cricoid Cartilage and trachea makes it impossible to standardize the rigid stents used in these organs. When transplantation to the larynx is planned, this variation of the anatomy must be considered.

Jong Bum Choi - One of the best experts on this subject based on the ideXlab platform.

  • Variations in the distance between the Cricoid Cartilage and targets of stellate ganglion block in neutral and extended supine positions: an ultrasonographic evaluation
    Journal of Anesthesia, 2016
    Co-Authors: Jiwon An, Sungchul Park, Woo Young Park, Hyungbae Park, Jong Bum Choi
    Abstract:

    Purpose Anatomic variations complicate surface landmark-guided needle placement, thereby increasing nerve blockade failure rate. However, little is understood about how anatomic distances change under different clinical conditions. As the Cricoid Cartilage is an easy and accurate landmark, we investigated changes in distance between the sixth or seventh cervical transverse processes (C6TP or C7TP) and the Cricoid Cartilage in neutral and extended supine positions. Methods Forty-two patients (16 men, 26 women) were included in this study. Distances between the Cricoid Cartilage and C6TP/C7TP were measured using ultrasonography with the patient in neutral and extended supine positions. Results C6TP and C7TP were caudally located at 6.0 ± 8.1 and 15.1 ± 7.2 mm, respectively, from the Cricoid Cartilage in the neutral supine position, and at 15.2 ± 8.0 and 25.3 ± 8.0 mm, respectively, in the extended supine position. In the extended supine position, the Cricoid Cartilage was more cephalad than C6TP and C7TP in all patients. The distance from the Cricoid Cartilage to C6TP was 12.1 ± 7.6 mm in men and 17.2 ± 7.7 mm in women. Conclusion C6TP and C7TP are located approximately 15 and 25 mm, respectively, caudal to the Cricoid Cartilage in the extended supine position. Our results highlight the fact that there can be significant anatomic variation between the extended and neutral supine positions used in stellate ganglion block, which should be kept in mind when devising easily identifiable and palpable surface landmarks.

  • Variations in the distance between the Cricoid Cartilage and targets of stellate ganglion block in neutral and extended supine positions: an ultrasonographic evaluation
    Journal of Anesthesia, 2016
    Co-Authors: Youn Woo Lee, Woo Young Park, Sungchul Park, Hyungbae Park, Ji Won Yoo, Jong Bum Choi
    Abstract:

    Anatomic variations complicate surface landmark-guided needle placement, thereby increasing nerve blockade failure rate. However, little is understood about how anatomic distances change under different clinical conditions. As the Cricoid Cartilage is an easy and accurate landmark, we investigated changes in distance between the sixth or seventh cervical transverse processes (C6TP or C7TP) and the Cricoid Cartilage in neutral and extended supine positions. Forty-two patients (16 men, 26 women) were included in this study. Distances between the Cricoid Cartilage and C6TP/C7TP were measured using ultrasonography with the patient in neutral and extended supine positions. C6TP and C7TP were caudally located at 6.0 ± 8.1 and 15.1 ± 7.2 mm, respectively, from the Cricoid Cartilage in the neutral supine position, and at 15.2 ± 8.0 and 25.3 ± 8.0 mm, respectively, in the extended supine position. In the extended supine position, the Cricoid Cartilage was more cephalad than C6TP and C7TP in all patients. The distance from the Cricoid Cartilage to C6TP was 12.1 ± 7.6 mm in men and 17.2 ± 7.7 mm in women. C6TP and C7TP are located approximately 15 and 25 mm, respectively, caudal to the Cricoid Cartilage in the extended supine position. Our results highlight the fact that there can be significant anatomic variation between the extended and neutral supine positions used in stellate ganglion block, which should be kept in mind when devising easily identifiable and palpable surface landmarks.

  • estimation of stellate ganglion block injection point using the Cricoid Cartilage as landmark through x ray review
    The Korean Journal of Pain, 2011
    Co-Authors: Jeongsoo Park, Duck Mi Yoon, Kyung Bong Yoon, Jong Bum Choi
    Abstract:

    Background Stellate ganglion block is usually performed at the transverse process of C6, because the vertebral artery is located anterior to the transverse process of C7. The purpose of this study is to estimate the location of the transverse process of C6 using the Cricoid Cartilage in the performance of stellate ganglion block. Methods We reviewed cervical lateral neutral-flexion-extension views of 48 patients who visited our pain clinic between January and June of 2010. We drew a horizontal line at the surface of the Cricoid Cartilage in the neutral and extension views of cervical lateral x-rays. We then measured the change in the shortest distance from this horizontal line to the lowest point of the transverse process of C6 between the neutral and extension views. Results There was a statistically significant difference in the shortest distance from the horizontal line at the surface of the Cricoid Cartilage to the lowest point of transverse process of C6 between neutral position and neck extension position in both males and females, and between males and females in both neutral position and neck extension position. The Cricoid Cartilage level was 4.8 mm lower in males and 14.4 mm higher in females than the lowest point of transverse process of C6 in neck extension position. Conclusions Practitioners should recognize that the Cricoid Cartilage has cephalad movement in neck extension. In this way, the Cricoid Cartilage can be still useful as a landmark for stellate ganglion block.

Ake Randestad - One of the best experts on this subject based on the ideXlab platform.

  • dimensions of the Cricoid Cartilage and the trachea
    Laryngoscope, 2000
    Co-Authors: Ake Randestad, Carleric Lindholm, Peter Fabian
    Abstract:

    OBJECTIVE Important dimensions of the Cricoid Cartilage and trachea have been studied. Knowledge of size, variations in size, and configuration of these structures is important when tracheal intubation, stenting, endoscopy, and transplantation are to be performed. METHODS In 34 male and 27 female adult human specimens, 1,861 measurements of the Cricoid Cartilage and trachea were performed. RESULTS The smallest dimension was found in the frontal plane. The mean inner diameter of the Cricoid in this plane with mucous membrane in situ was in women 11.6 mm (range, 8.9-17.0 mm) and in men 15.0 mm (range, 11.0-21.5 mm). The configuration varied more than expected. For example, the angle between the longitudinal axes of the cricoarytenoid joint facets ranged from 42 degrees to 74 degrees in women and from 37 degrees to 75 degrees in men. The mean distance between these joint facets was 10.3 mm (range, 7.4-13.0 mm) in women and 12.6 mm (range, 8.0-18.2 mm) in men. The cross-section of the trachea varied much in configuration, the smallest frontal diameter being as little as 9.9 mm in women and 12 mm in men. CONCLUSIONS In some women the inner diameter of the Cricoid ring does not permit passage of a standard-size (7 mm, internal diameter [ID]) tracheal tube or a standard-size rigid endoscope through the larynx without mucosal damage. The small distance between the cricoarytenoid joints in many women and some men is the basis for of the clinical observation that women, especially, receive pressure necroses at the medial sides of the arytenoid Cartilages attributable to tracheal intubation with standard tubes. The large difference in almost all sizes and shapes of the Cricoid Cartilage and trachea makes it impossible to standardize the rigid stents used in these organs. When transplantation to the larynx is planned, this variation of the anatomy must be considered.

B. Chepeha - One of the best experts on this subject based on the ideXlab platform.

  • Microvascular Cricoid Cartilage Reconstruction With the Thoracodorsal Artery Scapular Tip Autogenous Transplant
    2016
    Co-Authors: Otological Society, Eric J. P. Chanowski, Mph Marc, J. Haxer, Ccc Douglas, B. Chepeha
    Abstract:

    Conservation laryngeal surgery has been limited by difficulties with partial resection of the Cricoid. Numerous options have been suggested that include temporoparietal flaps, free Cartilage grafts, radial forearm free tissue transfers, and tracheal autotransplantation with vascular carriers. The authors present a one-stage procedure for the reconstruction of the Cricoid Cartilage based on the thoracodorsal artery scapular tip (Tdast) autogenous trans-plant that uses the curved tip of the scapula and does not create a secondary tracheal defect. Because the Tdast is a vascularized graft it may withstand radiation treatment. Key Words: Thoracodorsal artery scapular tip transplant, scapular angle, scapular tip, Cricoid Cartilage, Cricoid reconstruction

Eric J. P. Chanowski - One of the best experts on this subject based on the ideXlab platform.