Aryepiglottic fold width in patients with epiglottitis: where should measurements be obtained?
OBJECTIVE
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.


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.


CONCLUSIONS
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.
John
S D
SD
Department of Radiology and Pediatrics, University of Texas Medical Branch, Galveston.
Swischuk
L E
LE
Hayden
C K
CK
Freeman
D H
DH
D002648:Child; D002675:Child, Preschool; D003440:Croup / Q000000981:diagnostic imaging / Q000473:pathology; D004825:Epiglottis / Q000000981:diagnostic imaging* / Q000473:pathology; D004826:Epiglottitis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007223:Infant; D012372:ROC Curve; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity