title: Comparison of two topographical airway length measurements in adults.
abstract: BACKGROUND
  A correct estimate of the tracheal tube insertion depth can prevent complications, including endobronchial intubation and vocal cord trauma. We evaluated a new topographical method for endotracheal tube positioning relative to the carina, using a well-known prior topographical method for comparison.
  
  
  METHODS
  One hundred adult (male 50, female 50) patients were studied. The comparison topographic length (in cm) was measured by adding the distance between the right mouth corner and the right mandibular angle to the distance between the right mandibular angle and the center of the sternal manubrium. The new endotracheal tube insertion depth (in cm) was determined by adding the distance between the right mouth corner and the vocal cords, measured with the endotracheal tube itself, to the distance between the thyroid prominence and the manubriosternal joint, and then subtracting 4 cm. After intubation, the endotracheal tube was positioned properly at the right mouth corner and the endotracheal tube tip was evaluated using a fiberoptic bronchoscope at the carina.
  
  
  RESULTS
  The distances from the tip of the endotracheal tube to the carina were not significantly different between the methods in the same gender. However, our method allowed endotracheal tube tip placement between 3 cm and 5 cm, above the carina more frequently than the prior method in males.
  
  
  CONCLUSIONS
  The new topographical method can be used as a guide to positioning the endotracheal tubes.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Seoul, Korea.
authors.forename: Bo-Rum
authors.initials: BR
authors.lastname: Choi
authors.forename: Song-Yi
authors.initials: SY
authors.lastname: Lee
authors.forename: Jun-Young
authors.initials: JY
authors.lastname: Chung
authors.forename: Sung-Wook
authors.initials: SW
authors.lastname: Park
authors.forename: Wha Ja
authors.initials: WJ
authors.lastname: Kang
authors.forename: Jong-Man
authors.initials: JM
authors.lastname: Kang