Ultrasound: A novel tool for airway imaging

Abstract

Context:The scope of ultrasound is emerging in medical science, particularly outside traditional areas of radiology practice.Aims:We designed this study to evaluate feasibility of bedside sonography as a tool for airway assessment and to describe sonographic anatomy of airway.Settings and Design:A prospective, clinical study.Materials and Methods:We included 100 adult, healthy volunteers of either sex to undergo airway imaging systemically starting from floor of the mouth to the sternal notch in anterior aspect of neck by sonography.Results:We could visualize mandible and hyoid bone as a bright hyperechoic structure with hypoechoic acoustic shadow underneath. Epiglottis, thyroid cartilage, cricoid cartilage, and tracheal rings appeared hypoechoic. Vocal cords were visualized through thyroid cartilage. Interface between air and mucosa lining the airway produced a bright hyperechoic linear appearance. Artifacts created by intraluminal air prevented visualization of posterior pharynx, posterior commissure, and posterior wall of trachea.Conclusions:Ultrasound is safe, quick, noninvasive, repeatable, and bedside tool to assess the airway and can provide real-time dynamic images relevant for several aspects of airway management.

A feasibility study to assess vallecula and pyriform sinus using protocol-based ultrasonic evaluation of floor of mouth and upper airway

“…Further, literature recommends scanning of floor of mouth and tongue using a curvilinear probe. [6212223] Although this decision may be at the discretion of the user, in our experience, we found linear transducer in two oblique coronal views (anterior and posterior; Figures 2 and 3 respectively) friendly for scanning the floor of the mouth which is relatively superficial. Moreover, posterior floor can allow the assessment of submandibular duct and lingual vessels.…”

Practical aspects and training in fibreoptic intubation

“…New developments such as percutaneous ultrasound imaging of airway anatomy have been describeddbony structures, cartilaginous structures of the airway and vocal cords can be easily visualised, however, the posterior wall of the trachea and pharynx cannot be visualised due to artefactual distortion by air [8,9]. Nonetheless, ultrasound can be used to evaluate airway pathology (e.g.…”

Emerging Role of Ultrasound in Dysphagia Assessment and Intervention: A Narrative Review

“…The structure and movement of vocal folds could be directly observed by B-mode ultrasound ( Figure 5 ). A prospective study reported repeatable results of US observation of airway structures, such as, the tongue, the hyoid bone, the thyrohyoid membrane, the epiglottis, the thyroid cartilage, the vocal cords, the cricoid cartilage, the cricothyroid membrane, and the trachea ( 22 ). A multi-institutional observational study indicated the high sensitivity of US to detect vocal cord paralysis, although the visibility ranged from 41 to 86% (lower in male than in female) and was highly operator-dependent ( 67 ).…”

“…In this regard, ultrasonography (US) has attracted increasing attention as a potential tool for the evaluation of swallowing function, owing to its non-invasiveness, radiation-free characteristic, accessibility, and negligible influence on the normal swallowing process ( 13 , 14 ). US provides excellent resolution in depicting orofacial and neck musculatures ( 15 – 19 ) and has been used to observe airway and vocal folds movement ( 18 , 20 – 22 ). Many studies have applied US to evaluate tongue and hyolaryngeal movement ( 23 – 30 ).…”