Radiology, Vol 190, 123-125, Copyright © 1994 by Radiological Society of North America
Aryepiglottic fold width in patients with epiglottitis: where should measurements be obtained?
SD John, LE Swischuk, CK Hayden Jr and DH Freeman Jr
Department of Radiology and Pediatrics, University of Texas Medical Branch, Galveston.
PURPOSE: To determine the best site for measurement or assessment of the
aryepiglottic folds and determine whether evaluation of the lower portion
of the folds is useful. MATERIALS AND METHODS: The lateral neck radiographs
from 38 children with epiglottitis were retrospectively reviewed and
compared with findings in 100 patients with croup and 100 control patients.
In all patients, the fold thickness was measured at three levels: at the
midpoint (site 1), just behind the epiglottis (site 2), and at the base,
just above the false vocal cords (site 3). RESULTS: Full-thickness
measurements obtained at sites 1 and 2 were statistically significant
predictors of epiglottitis (sensitivity, 94.74%; specificity, at least
96.50%) in comparison with those obtained in patients with croup and
control patients. CONCLUSION: The best site for width assessment is the
upper half of the folds. Measurement at the base, where the folds overlie
the arytenoid cartilage, is not nearly as accurate and should be avoided.
