Wani Tariq M, Rafiq Mahmood, Talpur Salman, Soualmi Lahbib, Tobias Joseph D
Department of Anesthesia, King Fahad Medical City, Riyadh, Saudi Arabia.
Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Paediatr Anaesth. 2017 Jun;27(6):604-608. doi: 10.1111/pan.13116. Epub 2017 Mar 17.
Computed tomography- (CT) and magnetic resonance imaging (MRI)-based measurements have recently suggested that the narrowest dimension of the pediatric airway is the subglottic region. These data are contrary to the previously held tenets of a funnel- or conical-shaped airway. The current study evaluates airway volumes and shapes using three-dimensional CT images of the air way column in spontaneously breathing children.
The study included CT-based radiological images of the neck in children who required imaging unrelated to airway symptomatology. The children were evaluated during spontaneous ventilation during natural sleep or with sedation without airway devices in place. The three-dimensional images of the airway column were evaluated, volumes calculated, and comparisons made between the subglottic, cricoid, and tracheal volumes and shapes.
The study cohort included 54 children, ranging in age from 2 months to 8 years. An increase in the airway volumes was observed from the subglottic (0.17 ± 0.06 mm ) to the cricoid (0.19 ± 0.06 mm ) to the tracheal regions (0.22 ± 0.07 mm ). The volumes of the subglottic, cricoid, and tracheal regions demonstrated a linear relationship with age.
This study confirms recent studies demonstrating that the subglottic region not the cricoid is the narrowest part of the airway.
基于计算机断层扫描（CT）和磁共振成像（MRI）的测量最近表明，小儿气道最狭窄的部位是声门下区域。这些数据与之前认为气道呈漏斗状或圆锥状的观点相悖。本研究使用自主呼吸儿童气道柱的三维CT图像评估气道容积和形状。
该研究纳入了因与气道症状无关的原因而需要进行成像检查的儿童的颈部CT放射图像。在自然睡眠期间或在未使用气道装置的镇静状态下对儿童进行自主通气时进行评估。对气道柱的三维图像进行评估，计算容积，并比较声门下、环状软骨和气管的容积及形状。
研究队列包括54名年龄在2个月至8岁之间的儿童。观察到从声门下（0.17±0.06立方毫米）到环状软骨（0.19±0.06立方毫米）再到气管区域（0.22±0.07立方毫米）气道容积增加。声门下、环状软骨和气管区域的容积与年龄呈线性关系。
本研究证实了最近的研究结果，即气道最狭窄的部位是声门下区域而非环状软骨。
