ENT Updates
Original Article

Pediatric Laryngeal Measurements Based on Computed Tomography Images


Department of Otolaryngology and Head and Neck Surgery, Koç University School of Medicine, İstanbul Turkey


Department of Radiology, Koç University School of Medicine, İstanbul, Turkey

ENT Updates 2022; 12: 91-96
DOI: 10.5152/entupdates.2022.22167
Read: 1925 Downloads: 506 Published: 01 August 2022

Background: This study aimed to establish average laryngeal measurements in the Turkish pediatric population and measure the narrowest portion of the pediatric airway.

Methods: The laryngeal measurements of 88 pediatric patients between the ages 0 and 17 were retrospectively obtained from neck computed tomography scans performed between January 2018 and May 2021. Subjects were divided into 6 age groups. Four following measurements were made: cricoid anteroposterior, cricoid transverse, subglottic anteroposterior, and subglottic transverse. Cross-sectional areas were calculated using these dimensions. Subglottic cross-sectional area/cricoid crosssectional area ratio for each subject was calculated and patients were divided into 2 groups: group 1, subjects with ratio < 1; group 2, subjects with ratio ≥ 1.

Results: Mean age was 8.97 ± 5.7. Mean anteroposterior diameters at subglottis and cricoid ring levels were 13.74 ± 4.45 mm and 13.26 ± 4.39 mm; mean transverse diameters were 7.88 ± 2.62 mm and 9.06 ± 3.12 mm, respectively. The subglottic anteroposterior diameter was greater than cricoid (P < .001), but the transverse diameter was smaller than cricoid (P < .001). Subglottic cross-sectional area was 93.24 ± 59.20 mm2 and cricoid
cross-sectional area was 103.61 ± 69.15 mm2. Subglottic cross-sectional area/cricoid cross-sectional area ratio was smaller than 1 in 69 subjects (group 1; mean = 0.85) and equal to or greater than 1 in 19 subjects (group 2; mean = 1.33).

Conclusion: The narrowest portion of the airway was subglottis immediately below the vocal cords, in contrast to the common belief as to the cricoid ring. Subglottic cross-sectional area/cricoid cross-sectional area ratios showed that the pediatric airway was larger at cricoid (69 subjects, 78.4%), and this ratio does not differ based on age.

Cite this article as: Ünsaler S, Gökler O, Aygün SM, et al. Pediatric laryngeal measurements based on computed tomography images. ENT Updates. 2022;12(2):91-96.

EISSN 2149-6498