Navsa N, Tossel G, Boon J M
Department of Anatomy, Section of Clinical Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa.
Paediatr Anaesth. 2005 May;15(5):402-6. doi: 10.1111/j.1460-9592.2005.01470.x.
Airway management of the neonate remains a cornerstone in neonatal resuscitation which in most cases involves tracheal intubation. However, difficult intubations do occur. Cricothyroidotomy is recognized as an entry point below the vocal cords. This procedure becomes increasingly difficult in young children and is not recommended in children under the age of 5 years. Little is known about the anatomy of the neonatal airway, especially the size of the cricothyroid membrane. The aim of the study was to determine the dimensions of the cricothyroid membrane in neonates.
Twenty-seven neonatal cadavers (mean height of 44.89 cm and a mean weight of 2.05 kg) were carefully dissected and the dimensions of the cricothyroid membrane recorded with a digital caliper (accuracy 0.01 mm) by two independent observers.
The cricothyroid membrane has a mean height of 2.61 mm (sd: 0.71) and width of 3.03 mm (sd: 0.63).
Results of this study indicate that the dimensions of the cricothyroid membrane are too small for passing a tracheal tube as the dimensions of the tube exceeds that of the cricothyroid membrane. This could fracture the cartilages of the larynx. The performance of a surgical cricothyroidotomy with passing of a tracheal tube is therefore strongly discouraged in neonatal patients.
新生儿气道管理仍然是新生儿复苏的基石，在大多数情况下需要进行气管插管。然而，确实会出现插管困难的情况。环甲膜切开术被认为是声门以下的一个进入点。该手术在幼儿中实施难度越来越大，不建议在5岁以下儿童中进行。关于新生儿气道的解剖结构，尤其是环甲膜的大小，人们了解甚少。本研究的目的是确定新生儿环甲膜的尺寸。
仔细解剖27具新生儿尸体（平均身高44.89厘米，平均体重2.05千克），由两名独立观察者用数字卡尺（精度0.01毫米）记录环甲膜的尺寸。
环甲膜平均高度为2.61毫米（标准差：0.71），宽度为3.03毫米（标准差：0.63）。
本研究结果表明，由于气管导管的尺寸超过了环甲膜的尺寸，环甲膜的尺寸过小，无法通过气管导管。这可能会导致喉软骨骨折。因此，强烈不建议在新生儿患者中进行带气管导管通过的外科环甲膜切开术。
