title: Anthropometric measurements: effect of CT depth of pretracheal soft tissue on tracheotomy tube selection.
abstract: OBJECTIVE
  Tracheotomy is a commonly performed procedure; however, in the obese, it can be associated with a high morbidity and mortality, partially due to accidental decannulation. We hypothesize that a simple and rapid measurement of the DPST on CT will accurately predict those patients in need of an extended-length tracheotomy tube.
  
  
  METHODS
  A retrospective review of the electronic health record and available CT imaging of the neck was performed for all patients who underwent tracheotomy at a tertiary care center. Measurement of the DPST was performed and compared with the recorded tracheotomy tube used at surgery.
  
  
  RESULTS
  Five hundred twenty-two adult patients underwent an initial tracheotomy procedure, of whom 293 met the inclusion criteria for the study. A statistically significant correlation between the DPST and the need for an extended-length tracheotomy tube was seen. A discriminatory soft-tissue depth indicating the need for an extended-length tracheotomy tube was calculated.
  
  
  CONCLUSIONS
  CT measurement of the anterior soft-tissue depth is a simple tool that appears to provide a discriminatory threshold for the need for an extended-length tracheotomy tube. Further validation of this model through prospective application is needed. Although routine use of CT as a pretracheotomy evaluation is not advocated, the anatomic information is often available through prior imaging and has the potential to decrease the incidence of tracheotomy tube dislodgement in the obese and subsequent morbidity.
authors.affiliation: Department of Radiology, Geisinger Medical Center, Danville, Pennsylvania, USA. robert.n.walker@gmail.com
authors.forename: R N
authors.initials: RN
authors.lastname: Walker
authors.forename: I J
authors.initials: IJ
authors.lastname: Alexander
authors.forename: J A
authors.initials: JA
authors.lastname: Sartorius
authors.forename: C A
authors.initials: CA
authors.lastname: Woomert
mesh_terms: D000328:Adult; D000886:Anthropometry / Q000379:methods; D005260:Female; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D017755:Prosthesis Fitting / Q000379:methods / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014132:Trachea / Q000000981:diagnostic imaging* / Q000601:surgery; D014140:Tracheotomy / Q000295:instrumentation* / Q000706:statistics & numerical data*; D016896:Treatment Outcome