Comparison of ultrasound and surface landmarks to detect the localization for cricothyroidotomy

Surgical airway is a rarely needed and an important procedure though complications during the procedure nay cause morbidity and mortality. Studies have showed that the incidence of difficult airway is 3% and surgical airway is only needed in 0.6% of these patients. Although, cricothyroid membrane is superficial and surface landmarks are easily palpated, obes patients, patients with short neck, secondary conditions affecting neck region such as subcutaneous amphisema may complicate the situation and may increase the complication rate of surgical airway. In this study, to detect the cricothroidtomi application region in healthy volunteers, we compared USG and surface landmark palpation to detect cricothyroid membrane. Five operators and 24 models were included in this study. The Cricothyroid membrane was detected accurately in 80 (66.7%) attempts with palpation and 83 (69.2%) attempts with USG. There was no statistically significant difference in the accuracy of detecting cricothyriod membrane with palpation and USG. The mean and median time of detecting cricothyroid membrane with palpation was 8.25±4.8 seconds and 7 (IQR =5-11) second respectively. The mean and median time of detecting cricothyroid membrane with USG was 17±9.2 seconds and 14 (IQR 12-19) seconds respectively. There was statistically significant difference in terms of duration to detect cricothyroid membrane with botyh methods (p<0.001) and the duration to detect the localization of cricothyrid membrane was longer with USG. According the results of this study, the accuracy of USG and palpation was similar to detect the localization of cricothyriod membrane. The duration to detect the cricothyrid membrane was longer with USG when compared with palpation