The Clinical Anatomy of Cricothyroid Membrane – Its relevance to Emergent Subglottic Procedures.

Ivan James, Prithishkumar (2006) The Clinical Anatomy of Cricothyroid Membrane – Its relevance to Emergent Subglottic Procedures. Masters thesis, Madras Medical College, Chennai.


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The cricothyroid membrane is an important route for several other subglottic procedures as well. Though several authors and textbooks have mentioned the cricothyroid membrane, few have described its attachments and very few have studied its dimensions. Only two adult studies have been documented till date; both of which are western studies done in the United States of America. No studies have documented the dimensions of the cricothyroid membrane in children. Only one African study has documented dimensions of neonatal cricothyroid membranes. Race, heredity, climate and nutritional status are known to affect the body size of a population. It was my desire to study the dimensions of the cricothyroid membrane in our own South Indian population and also the structures at risk while puncturing the cricothyroid membrane. Based on my results, I suggest a vertical skin incision as it minimizes the chance of softtissue hemorrhage from vertically oriented anterior jugular veins. Palpation of the cricothyroid membrane should be repeated after the skin incision is made to confirm the correct position of the membrane. A transverse stab incision of the membrane near its lower border adjacent to the cricoid cartilage is recommended to avoid injury to the transverse cricothyroid artery. Tube sizes for emergent subglottic intubation have been reconsidered and new tube sizes suggested based on the present study to suit our south Indian population. To avoid or manage complications of surgical cricothyroidotomy, knowledge of the dimensions, relations, and vasculature of the cricothyroid membrane is imperative. A solid knowledge of the anatomy behind a cricothyroidotomy may reduce the anxiety of the physicians and paramedics performing the procedure. Cricothyroidotomy remains to be a safe and rapid means of securing emergency airway access in the absence of contraindications. This is the largest study done so far and the first study done on a non-American adult group and the first done on a non-African neonatal racial group. It is also the first study done to report cricothyroid membrane dimensions in children. It is my sincere hope that these values would be of immense help in the field of emergency medicine, anesthesia, intensive care management and neonatal care of the newborn.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Cricothyroid Membrane; Clinical Anatomy; Emergent Subglottic Procedures.
Subjects: MEDICAL > Anatomy
Depositing User: Kambaraman B
Date Deposited: 22 Jun 2017 05:29
Last Modified: 22 Jun 2017 06:28

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