Ultrasound Assessment of Larynx and Trachea in the Neonatal Period, Examination Standard with Predictive Values—Study Protocol
Abstract
:1. Introduction
2. Experimental Design
3. Materials and Equipment
- Gestational age ≥32 weeks.
- Gestational age <32 weeks;
- Presence of significant congenital anomalies;
- Intubated neonate;
- Unstable neonate.
4. Details of the Procedure
4.1. Test Methods
- Width of the larynx at the level of the glottis (measurement taken in the transverse plane from the external margins of the thyroid cartilage) (Figure A2);
- Depth of the larynx at the level of the glottis (measurement taken in the transverse view from the external margin of the thyroid cartilage to the external border of the annular cartilage) (Figure A2);
- Thickness of the thyroid cartilage in the midline and on both sides transversely at the level of the glottis (in the transverse plane measurement from external margins of thyroid cartilage and vertical measurement of thyroid cartilage above the anterior commissure at the level of well-visualized arytenoid cartilages in the transverse plane) (Figure A3);
- Angle formed by the lamina of the thyroid cartilage (measurement taken in the transverse plane with two lines drawn tangentially to the thyroid laminae) (Figure A4);
- Width of the glottis during calm breathing (measured in the transverse plane with lines drawn between two medial margins of arytenoid glands when they are farthest apart during breathing) (Figure A5);
- Angle formed by the vocal cords during calm breathing, considering the opening angle of individual chords (measurement taken in the transverse plane with a line drawn from posterior part of the anterior commissure to the medial margins of the arytenoid gland) (Figure A6);
- Surface area of the glottis during calm exhalation (in order to avoid distorting the result of measuring the glottal area using the outline of its visible borders, this measurement will be taken by calculating the area of a triangle, the basis of which will be the width of the glottis, and the height will be the depth of the glottis measured from the posterior part of the anterior commissure to the line drawn to measure glottis width, measurement taken in the transverse plane) (Figure A7);
- Thickness of the arytenoid muscle during inhalation and exhalation (measurement taken in the transverse plane in the midline from the outer surfaces of this muscle) (Figure A8);
- Thickness of the vocal cords in transverse projections, tangentially to the midline (measure in the transverse, lateral plane, ventral and tangentially to the arytenoid cartilages) (Figure A9);
- Amplitude and duration of vocal cord movement during breathing at rest (measurement taken in the transverse, lateral plane, using M-mode as the distance between two lines drawn by the movement of the outer surface of the vocal cord—lighter than the surrounding lines);
- Width and depth of the trachea (measurement taken in the transverse plane of the longest transverse dimension of the trachea from the external edges of the tracheal cartilages and measurement of the longest depth of the trachea from the external margin of the tracheal cartilage to the outer part of the membranous wall) (Figure A10);
- Width and depth of the tracheal lumen (measurement made in the transverse plane of the longest transverse dimension and longest depth of the hypoechoic area limited by the inner edges of the tracheal cartilages and membranous wall of the trachea) (Figure A11);
- Thickness and width of the supraglottis (measurement taken in the transverse plane of the thickest and the widest visible part of the supraglottis) (Figure A12);
- Thickness of the preepiglottic space (measurement taken in the transverse plane of the thickest part) (Figure A13);
- Thickness of the infrahyoid muscles at the level of the thyroid cartilage and hyoid bone (measurement taken in the transverse view of the thickest dimension between the outer edges of thyrohyoid and sternohyoid muscles as a group of infrahyoid muscles in the transverse plane, at the level of well-visible hyoid bone and glottis) (Figure A14).
4.2. Analysis
5. Expected Results
6. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
References
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Paprocki, Ł.; Migda, B.; Bokiniec, R. Ultrasound Assessment of Larynx and Trachea in the Neonatal Period, Examination Standard with Predictive Values—Study Protocol. Diagnostics 2023, 13, 1578. https://doi.org/10.3390/diagnostics13091578
Paprocki Ł, Migda B, Bokiniec R. Ultrasound Assessment of Larynx and Trachea in the Neonatal Period, Examination Standard with Predictive Values—Study Protocol. Diagnostics. 2023; 13(9):1578. https://doi.org/10.3390/diagnostics13091578
Chicago/Turabian StylePaprocki, Łukasz, Bartosz Migda, and Renata Bokiniec. 2023. "Ultrasound Assessment of Larynx and Trachea in the Neonatal Period, Examination Standard with Predictive Values—Study Protocol" Diagnostics 13, no. 9: 1578. https://doi.org/10.3390/diagnostics13091578