Anatomy Review

The airway can be evaluated by ultrasound from the suprahyoid area to the suprasternal notch (Figure 1) in both the transverse and longitudinal planes. The transverse view is most commonly used to confirm the location of the ETT, but the longitudinal view can aid in landmarking when planning a surgical airway. 

 

Figure 1: Reproduced from Lin et al, Diagnostic 2023 [24]

 

Ultrasound Anatomy Review

The sonoanatomy of the airway includes important landmarks including the vocal cords (Figure 2 A-B), cricothyroid membrane (Figure 2 C-D), trachea, esophagus, thyroid cartilage and air-mucosa interface (Figure 2 E-F).  

Figure 2. Ultrasound image of A-B) transverse plane at the thyroid level showing the vocal cords (blue stars), C-D)  longitudinal plane over the cricothyroid membrane (yellow line), thyroid cartilage (blue circle), cricoid cartilage (green circle) and tracheal rings string of pearls (purple circles), E-F) transverse plane over the suprasternal notch showing the trachea (purple circle), esophagus (yellow circle) and thyroid (blue area) with the air-mucosa interface (green line).