title: The accuracy of anatomical landmarks for locating the carotid sinus.
abstract: carotid sinus massage (CSM) is a valuable clinical test for carotid sinus syndrome (CSS) and relies on accurately locating the carotid sinus (CS).
  
  
  
  in this study, we sought to examine the accuracy of using anatomical landmarks for locating the CS.
  
  
  
  consecutive patients (n = 20) were recruited prospectively. Two clinicians, trained in CSM, were asked to locate the CS using anatomical landmarks. A point on the skin overlying the CS was then marked by a vascular technician using ultrasound. Accuracy of techniques was compared using intra-class correlation coefficients and Bland-Altman statistics.
  
  
  
  anatomical landmarks underestimated the CS location by 1.5 ± 1.3 cm. Error extremes ranged from 4 cm below to 2 cm above CS using anatomical landmarks. A moderate correlation between ultrasound and anatomical landmarks was found, r = 0.371 (P = 0.031).
  
  
  
  this is the first study to characterise the accuracy of standard anatomical landmarks used in CSM. Results suggest that the point of maximal pulsation has the lowest associated error. Future work should examine CSM yield across this and a range of other methodological factors.
authors: Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland.|Department of Medical Physics and Bioengineering, St. James's Hospital, Dublin, Ireland.
authors: Ciaran
authors: C
authors: Finucane
authors: Department of Vascular and Endovascular Surgery, St. James's Hospital, Dublin, Ireland.
authors: Mary Paula
authors: MP
authors: Colgan
authors: Department of Medical Gerontology, St. Vincent's Hospital, Dublin, Ireland.
authors: Clodagh
authors: C
authors: O'Dwyer
authors: Department of Vascular and Endovascular Surgery, St. James's Hospital, Dublin, Ireland.
authors: Collette
authors: C
authors: Fahy
authors: Department of Medical Gerontology, St. Vincent's Hospital, Dublin, Ireland.
authors: Orla
authors: O
authors: Collins
authors: Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland.|Department of Medical Physics and Bioengineering, St. James's Hospital, Dublin, Ireland.
authors: Gerry
authors: G
authors: Boyle
authors: Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland.
authors: Rose Anne
authors: RA
authors: Kenny
mesh_terms: D000368:Aged; D059925:Anatomic Landmarks; D002346:Carotid Sinus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008405:Massage / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D014463:Ultrasonography
keywords: carotid sinus anatomy; carotid sinus massage; carotid sinus syndrome; falls; syncope