Westhorpe R N
Department of Anaesthesia and Intensive Care, Royal Children's Hospital, Melbourne, Australia.
Anaesth Intensive Care. 1987 Nov;15(4):384-8. doi: 10.1177/0310057X8701500405.
Lateral radiographs of the upper airway of children aged from birth to puberty were used to determine the changes in position, with growth, of the tip of the epiglottis, the hyoid, the glottis, and the inferior margin of the cricoid cartilage. There is a marked descent of these structures relative to the cervical spine during the first two years of life. Their position then remains fairly static until puberty, when further descent of laryngeal structures occurs. Using the same methods to determine ease of laryngoscopy with the head and neck in different positions it was shown that in infants the best view is obtained with the atlanto-occipital joint fully extended and the head and shoulders on a flat surface. In adults the best view is obtained with the atlanto-occipital joint fully extended and the head resting on a low pillow. Anatomical explanations for these observations are presented.
利用出生至青春期儿童上气道的侧位X线片来确定会厌尖、舌骨、声门和环状软骨下缘随生长在位置上的变化。在生命的头两年，这些结构相对于颈椎有明显下降。然后它们的位置相当稳定，直到青春期，此时喉部结构会进一步下降。采用相同方法确定在不同头颈部位置进行喉镜检查的难易程度，结果显示，婴儿在寰枕关节完全伸展且头和肩部置于平面时能获得最佳视野。成人在寰枕关节完全伸展且头靠在低枕头上时能获得最佳视野。文中给出了这些观察结果的解剖学解释。
