RT Journal Article
SR Electronic
T1 Anthropometric Measurements: Effect of CT Depth of Pretracheal Soft Tissue on Tracheotomy Tube Selection
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 449
OP 452
DO 10.3174/ajnr.A2823
VO 33
IS 3
A1 R.N. Walker
A1 I.J. Alexander
A1 J.A. Sartorius
A1 C.A. Woomert
YR 2012
UL http://www.ajnr.org/content/33/3/449.abstract
AB BACKGROUND AND PURPOSE: Tracheotomy is a commonly performed procedure; however, in the obese, it can be associated with a high morbidity and mortality, partially due to accidental decannulation. We hypothesize that a simple and rapid measurement of the DPST on CT will accurately predict those patients in need of an extended-length tracheotomy tube. MATERIALS AND METHODS: A retrospective review of the electronic health record and available CT imaging of the neck was performed for all patients who underwent tracheotomy at a tertiary care center. Measurement of the DPST was performed and compared with the recorded tracheotomy tube used at surgery. RESULTS: Five hundred twenty-two adult patients underwent an initial tracheotomy procedure, of whom 293 met the inclusion criteria for the study. A statistically significant correlation between the DPST and the need for an extended-length tracheotomy tube was seen. A discriminatory soft-tissue depth indicating the need for an extended-length tracheotomy tube was calculated. CONCLUSIONS: CT measurement of the anterior soft-tissue depth is a simple tool that appears to provide a discriminatory threshold for the need for an extended-length tracheotomy tube. Further validation of this model through prospective application is needed. Although routine use of CT as a pretracheotomy evaluation is not advocated, the anatomic information is often available through prior imaging and has the potential to decrease the incidence of tracheotomy tube dislodgement in the obese and subsequent morbidity. BMIbody mass indexCIconfidence intervalDPSTdepth of pretracheal soft tissueENTear, nose, and throatORodds ratio