Journals / Anatolian Current Medical Journal / 2026 / Volume: 8 Issue: 2

Investigation of relationship between neck anteroposterior-transvers diameters and trachea anteroposterior-transvers diameters based on CT scans

Cansu Şengül(Department of Radiology, Faculty of Medicine, Düzce University, Düzce, Turkiye)0009-0007-6009-9697
Ayşe Nur Belada(Düzce Atatürk Devlet Hastanesi Anesteziyoloji ve Reanimasyon)0009-0007-1336-3053
Pages
—
Publication Date
2026-03-10
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Neck measurements may serve as complementary anatomical indicators within a multifactorial airway assessment approach rather than as standalone predictors.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aims: The tracheal diameter may be influenced by external anatomical characteristics, and accurate estimation of airway dimensions is important for procedural planning.
📊
Key Findings & Data:Methods: A total of 180 adult patients were retrospectively included in the study.
💡
Conclusion & Impact:Neck measurements may serve as complementary anatomical indicators within a multifactorial airway assessment approach rather than as standalone predictors.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Tracheal diameter · neck diameter · airway management

Abstract

Aims: The tracheal diameter may be influenced by external anatomical characteristics, and accurate estimation of airway dimensions is important for procedural planning. This study aimed to evaluate the anatomical relationship between neck and tracheal dimensions using radiological measurements in the anteroposterior (AP) and transverse (TR) planes. Methods: A total of 180 adult patients were retrospectively included in the study. The AP and TR diameters of the first tracheal ring and the AP and TR diameters of the neck at the level of the cricoid cartilage were measured on computed tomography (CT) images. Body mass index was calculated from recorded height and weight data. Correlation analyses and multiple linear regression models adjusted for age, sex, and body mass index were performed. Results: Significant sex-related differences were observed in tracheal AP and TR diameters (trachea AP: 19.97±2.10 mm vs. 16.32±1.87 mm; trachea TR: 20.00±1.67 mm vs. 16.14±1.69 mm; both p<0.001). Significant differences were also found in neck dimensions between males and females (neck AP: 141.56±14.64 mm vs. 123.79±20.41 mm; p<0.001; neck TR: 126.24±12.97 mm vs. 120.12±12.99 mm; p=0.002). Correlation analysis demonstrated statistically significant associations between tracheal and neck measurements. In multivariable regression analysis, neck AP diameter and sex were significantly associated with both tracheal AP and TR diameters. Conclusion: Tracheal and neck dimensions measured on CT were statistically associated, with stronger relationships observed in AP measurements. However, the magnitude of these associations was limited, indicating that external neck measurements alone are insufficient for precise prediction of tracheal size. Neck measurements may serve as complementary anatomical indicators within a multifactorial airway assessment approach rather than as standalone predictors.

🔖

Cite This Article

Belada, A., Şengül, C., Özel, M. A., Ünlü, İ., Subaşı, B., Güçlü, E., Belada, A. N., Önbaş, Ö. (2026). Investigation of relationship between neck anteroposterior-transvers diameters and trachea anteroposterior-transvers diameters based on CT scans. Anatolian Current Medical Journal, Volume: 8 Issue: 2. https://doi.org/10.38053/acmj.1857103

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (21)

  1. Shiga T, Wajima Z, Inoue T, Sakamoto A. Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance. Anesthesiology. 2005;103(2):429-437. doi:10.1097/00000542
  2. Shah PN, Sundaram V. Incidence and predictors of difficult mask ventilation and intubation. J Anaesthesiol Clin Pharmacol. 2012;28(4): 451. doi:10.4103/0970-9185.101901
  3. Liaqat T, Amjad MA, Cherian SV. Difficult airway management in the intensive care unit: a narrative review of algorithms and strategies. JCM. 2025;14(14):4930. doi:10.3390/jcm14144930
  4. Fenley H, Voorman M, Dove JT, Greene JS. Predicting pediatric tracheal airway size from anthropomorphic measurements. Int J Pediatr Otorhinolaryngol. 2020;134:110020. doi:10.1016/j.ijporl.2020.110020
  5. Ndoko SK, Amathieu R, Tual L, et al. Tracheal intubation of morbidly obese patients: a randomized trial comparing performance of Macintosh and AirtraqTM laryngoscopes. Br J Anaesth. 2008;100(2):263-268. doi:10.1093/bja/aem346
  6. Coordes A, Rademacher G, Knopke S, et al. Selection and placement of oral ventilation tubes based on tracheal morphometry. The Laryngoscope. 2011;121(6):1225-1230. doi:10.1002/lary.21752
  7. Çelik G, Zengin S, Orhon Ergün M, Umuroğlu T. Correlation between neck circumference measurement and obesity type with difficult intubation in obese patients undergoing elective surgery. J Surg Med. 2021;5(9):912-916. doi:10.28982/josam.989262
  8. Sakuraba S, Serita R, Kuribayashi J, et al. Comparison of tracheal diameter measured by chest x-ray and by computed tomography. Anesthesiol Res Pract. 2010;2010:1-3. doi:10.1155/2010/269171
  9. Ap Dafydd D, Desai SR, Gordon F, Copley SJ. Tracheal CT morphology: correlation with distribution and extent of thoracic adipose tissue. Eur Radiol. 2016;26(10):3669-3676. doi:10.1007/s00330-016-4205-x
  10. El-Anwar MW, El-Hussiny A, Osman H, Mobasher MA. Tracheal and subglottic dimensions: a computed tomography cross section study of adult population. Egypt J Otolaryngol. 2024;40(1):25. doi:10.1186/s43163-024-00588-3
  11. Greenland KB, Edwards MJ, Hutton NJ, Challis VJ, Irwin MG, Sleigh JW. Changes in airway configuration with different head and neck positions using magnetic resonance imaging of normal airways: a new concept with possible clinical applications. Br J Anaesth. 2010;105(5):683-690. doi:10.1093/bja/aeq239
  12. Kristensen MS. Ultrasonography in the management of the airway. Acta Anaesthesiol Scand. 2011;55(10):1155-1173. doi:10.1111/j.1399-6576.2011. 02518.x
  13. Kim WH, Ahn HJ, Lee CJ, et al. Neck circumference to thyromental distance ratio: a new predictor of difficult intubation in obese patients. Br J Anaesth. 2011;106(5):743-748. doi:10.1093/bja/aer024
  14. D’Anza B, Knight J, Greene JS. Does body mass index predict tracheal airway size? Laryngoscope. 2015;125(5):1093-1097. doi:10.1002/lary.24943
  15. Gonzalez H, Minville V, Delanoue K, Mazerolles M, Concina D, Fourcade O. The importance of increased neck circumference to intubation difficulties in obese patients. Anesth Analg. 2008;106(4):1132-1136. doi:10.1213/ane.0b013e3181679659
  16. Karmakar A, Pate MB, Solowski NL, Postma GN, Weinberger PM. Tracheal size variability is associated with sex: implications for endotracheal tube selection. Ann Otol Rhinol Laryngol. 2015;124(2):132-136. doi:10.1177/0003489414549154
  17. Schiff BA. The relationship between body mass, tracheal diameter, endotracheal tube size, and tracheal stenosis. Int Anesthesiol Clin. 2017; 55(1):42-51. doi:10.1097/AIA.0000000000000127
  18. Lebowitz PW, Shay H, Straker T, Rubin D, Bodner S. Shoulder and head elevation improves laryngoscopic view for tracheal intubation in nonobese as well as obese individuals. J Clin Anesth. 2012;24(2):104-108. doi:10.1016/j.jclinane.2011.06.015
  19. Jung H. A comprehensive review of difficult airway management strategies for patient safety. Anesth Pain Med. 2023;18(4):331-339. doi:10. 17085/apm.23123
  20. Nørskov AK, Rosenstock CV, Wetterslev J, Astrup G, Afshari A, Lundstrøm LH. Diagnostic accuracy of anaesthesiologists’ prediction of difficult airway management in daily clinical practice: a cohort study of 188 064 patients registered in the Danish Anaesthesia Database. Anaesthesia. 2015;70(3):272-281. doi:10.1111/anae.12955
  21. Freitas RK, Schröder W. Numerical investigation of the three-dimensional flow in a human lung model. J Biomech. 2008;41(11):2446-2457. doi:10.1016/j.jbiomech.2008.05.016