Diagnostic Imaging of the Larynx

Prevertebral Soft Tissue Thickness among Pediatric Patients

“…In the evaluation of PVST, otorhinolaryngologists in our institution use criteria contained in Cummings' Textbook of Otolaryngology Head and Neck Surgery. 2,3 The three sets of criteria contained therein have sparked debate as to which should be used. The first (by Duncan) stating that the PVST at C2 should not exceed twice the diameter of the C2 vertebral body cited a 1991 study by Coulthard.…”

“…The assessment of the PVST is critical especially when any pathologic condition involving the PVST poses danger of obstructing the airway warranting tracheostomy tube insertion or any other life saving intervention. At our institution's Department of Medical Imaging, the PVSTs of requested soft tissue lateral neck x-rays are measured and compared to the standards published in the Atlas of Roentgenographic Measurement by Keats and Lusted which adopted a 1939 study by Hay et al 1 The Department of Otorhinolaryngology Head and Neck Surgery however uses criteria contained in the Textbook of Otorhinolaryngology Head and Neck Surgery by Cummings et al 2,3 In fact, within this textbook are three (3) standards: the first by Duncan on the chapter on Infections of the Airway 2 and the second and third by Wippold in the chapter on Diagnostic Imaging of the Larynx. 3 This difference in standards often poses problems for practitioners making their resolution significant in the management of patients.…”

“…At our institution's Department of Medical Imaging, the PVSTs of requested soft tissue lateral neck x-rays are measured and compared to the standards published in the Atlas of Roentgenographic Measurement by Keats and Lusted which adopted a 1939 study by Hay et al 1 The Department of Otorhinolaryngology Head and Neck Surgery however uses criteria contained in the Textbook of Otorhinolaryngology Head and Neck Surgery by Cummings et al 2,3 In fact, within this textbook are three (3) standards: the first by Duncan on the chapter on Infections of the Airway 2 and the second and third by Wippold in the chapter on Diagnostic Imaging of the Larynx. 3 This difference in standards often poses problems for practitioners making their resolution significant in the management of patients. This study aims to determine the prevertebral soft tissue thickness among normal patients aged 0-14 years old in our institution, to compare these values with divergent criteria in the standard otorhinolaryngology and radiology texts used in our institution, and to recommend adoption of a set of criteria based on the results.…”