Normal airway anatomy (ultrasound)

Case contributed by David Carroll
Diagnosis not applicable


Asymptomatic. Normal anatomical scans for reference.

Patient Data

Age: 30 years
Gender: Male

Normal airway anatomy for reference.

Case Discussion

As demonstrated above, ultrasound can be used to visualize laryngotracheal structures, and may be useful as an adjunct to more established imaging modalities for both procedural and diagnostic applications.

First paired image and cine-loop in a transverse orientation just superior to the sternal notch; isthmus and right lobe of the thyroid in the near field overlying the anterior aspect of the trachea. Esophagus barely visible until distended by air, located deep and lateral to the trachea, medial to longus colli, posterior to right lobe of the thyroid gland, and superficial to the body of C6. Liquid was swallowed during the exam to elucidate its location.

Second pair of studies shows a longitudinal view of the trachea with a prominent, brightly echoic air-mucosal interface just below the cartilaginous rings 1. Prominent posterior reverberation artifacts. At the cephalad limit of the view the larger, more superficial ovoid inclusion is the cricoid cartilage.

Transverse probe orientation over the thyroid cartilage provides a view of the laryngeal structures; patient was phonating during exam, hence the brisk vocal cord adduction/abduction evident. 

The final two studies depict the thyrohyoid membrane, and the anisotropic honeycomb structure visible with probe fanning being the internal branch of the superior laryngeal nerve 2. Prominent acoustic shadowing from the body and lesser cornu of the hyoid.

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