Evaluation of Epiglottic Cartilage Morphometry Using Magnetic Resonance Imaging

Abstract

Aim: Epiglottic cartilage (EC) is an important larynx cartilage with elastic cartilage structure. Functionally, this structure, which acts as a gate between the larynx and the pharynx, can be damaged due to difficult intubation during the advancement of the endotracheal tube. The aim of this study; EC’s morphometric relationship with the surrounding anatomical structures is to be examined and to minimize the complications that occur in clinical applications in line with the data obtained. Materials and Methods: In the study, cervical MRI series of 79 females and 53 males aged 20 years and older were obtained from Balikesir University PACS system archive and analyzed retrospectively. The morphometric analysis of the obtained images was carried out by transferring them to the Radiant DICOM Viewer software. In the study, the distance of EC to the surrounding anatomical structures, the angle of the visceral region between the stalk of epiglottis (SE) and the thyroid cartilage (ThC), and the lengths of the fixed and free part of EC were evaluated. The data evaluated in the study were statistically analyzed using SPSS software. Results: The length values analyzed statistically in the study tended to be higher in male individuals than in female individuals. However; It was observed that the visceral region angle between SE and (ThC) tended to be higher in female individuals than in male individuals. Age and larynx length (LL), the distance of apex part of epiglottic cartilage (AEC) to root of tongue (RT), and the length of the free part of epiglottic cartilage (FEC) showed a positive correlation. The mean length of larynx was 2.45 ± 0.53 cm according to the determined reference points. Conclusion: As a result of the values reached, clinicians will be able to have an idea about the distance of AEC to RT by measuring the LL with palpation just before endotracheal intubation. Based on this, it is thought that possible EC injuries can be prevented by predicting difficult intubation.