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Emergency cricothyroidotomy in the patient with massive neck swelling: Part 1 Anatomical aspects

A method for localizing the hyoid bone in normal adult and children subjects is presented. The reliability of this calculated value in permitting localization of the hyoid was examined in 200 adult subjects in relationship to age, sex, neck size, and ethnic origin. The same method was utilized in 198 children with similar results. It was found to be a constant and remarkably predictable dimension which was unaffected by any of these variables. Because the hyoid serves as a frame from which the respiratory passage is suspended, it can be easily located and used to stabilize and retract superiorly and anteriorly the larynx and trachea, allowing easier access to these structures by a tracheotomy or criocothyroidotomy in the patient with massive neck swelling where emergency tracheotomy or cricothyroidotomy are difficult.