Estimation of the nares-to-epiglottis distance and the nares-to-vocal cords distance in young children

• Published in: British journal of anaesthesia : BJA Vol. 109; no. 5; pp. 816 - 820
• Main Authors: Kim, S.H., Kim, D.H., Kang, H, Park, J.J., Seong, S.H., Suk, E.H., Hwang, J.H.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-11-2012; Oxford University Press
• Subjects: airway anatomy; airway management; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Body Weights and Measures - methods; Child; Child, Preschool; Epiglottis - anatomy & histology; Female; fibreoptic intubation; Humans; Infant; Male; Medical sciences; nasopharyngeal airway; nasotracheal intubation; Nose - anatomy & histology; paediatric anaesthesia; Vocal Cords - anatomy & histology; airway anatomy; fibreoptic intubation; nasotracheal intubation; airway management; nasopharyngeal airway; paediatric anaesthesia; Human; Estimation; Anatomy; Vocal cord; Clinical management; Anesthesia; Intubation; Child
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/aes267

Estimation of the nares-to-epiglottis and nares-to-vocal cords distances would facilitate the selection of properly sized nasopharyngeal airways and appropriate positioning of a fibreoptic bronchoscope in young children. The purposes of this study were to measure the nares-to-epiglottis and nares-to-vocal cords distances and to create an algorithm to predict these distances based on anatomical landmarks and paediatric characteristic data.
Two hundred and eleven children, aged 1–10 yr, undergoing elective surgery were investigated. After induction of general anaesthesia, the distances from the nares to the epiglottis/vocal cords were measured using a nasogastric tube. After intubation, the distances from the lateral border of the nose to the ipsilateral mandible angle (nares-to-mandible distance) and the tragus of the ear (nares-to-tragus distance) were measured using a tape measure.
The nares-to-epiglottis and nares-to-vocal cords distances were significantly correlated with the age, weight, height, and external measurements (P<0.001). By stepwise multiple linear regression analysis, formulas were obtained for the nares-to-epiglottis distance (cm)=2.606+0.058×height (cm)+0.231×the nares-to-mandible distance (cm)−0.304 (gender) (r2=0.754) and for the nares-to-vocal cords distance (cm)=4.947+0.06×height (cm)+0.228×nares-to-mandible distance (cm)−0.283 (gender) (r2=0.803).
The nares-to-epiglottis and nares-to-vocal cords distances can be predicted using the height and the nares-to-mandible distance in young children.
Clinical Trial Registration number: Clinical Research Information Service KCT0000150.