Related Experiment Video
Updated: May 31, 2026
Image Acquisition using Portable Sonography for Emergency Airway Management
Published on: September 28, 2022
Multidetector computed tomography (MDCT) for preoperative airway assessment in children with mucopolysaccharidoses
P M Ingelmo1, R Parini, M Grimaldi
1First Service of Anesthesia and Intensive Care, San Gerardo Hospital, Monza, Italy. pabloingelmo@libero.it
Insights
Multidetector computed tomography (MDCT) aids airway management for children with mucopolysaccharidoses (MPS). MDCT imaging provided valuable insights in 87% of cases, influencing airway device selection for difficult intubations.
Area of Science:
- Anesthesiology
- Pediatric Radiology
- Medical Imaging
Background:
- Glycosaminoglycan accumulation in mucopolysaccharidoses (MPS) complicates anesthetic management.
- Standard evaluations often lack sufficient detail for upper airway assessment in MPS patients.
- Multidetector computed tomography (MDCT) is valuable for assessing airways in at-risk children but not typically used in MPS.
Purpose of the Study:
- To determine the utility of MDCT airway reconstruction in planning airway management for children with MPS.
- To assess if MDCT provides clinically relevant information beyond standard preoperative assessments for MPS patients.
Main Methods:
- A questionnaire-based study involving 26 pediatric anesthesiologists.
- Anesthesiologists developed initial airway management plans based on standard charts for 5 MPS children.
- A second plan was formulated after reviewing tracheal MDCT images for each patient.
Main Results:
- MDCT imaging yielded additional clinically relevant information in 87% of evaluations.
- Tracheal size reduction was the most frequent finding on MDCT.
- Anesthesiologists altered their primary airway device selection in 21% of cases after reviewing MDCT.
Conclusions:
- Airway reconstruction using MDCT from prior CT scans is a valuable tool.
- MDCT enhances preoperative airway evaluation and planning for MPS children.
- This imaging modality can improve anesthetic management strategies in this patient population.
Background:
Accumulation of glycosaminoglycans is known to cause significant problems in the anesthetic management of children with mucopolysaccharidoses (MPS). Clinical and standard radiological evaluation may convey insufficient information about the upper airway and trachea in children with MPS. Multidetector computed tomography (MDCT) images have been used to define the central airway and previous studies have recommended this tool to assess the airway of children who are considered at risk of difficult intubation. However, MDCT has not been recommended in MPS children. The aim of this clinical scenario study was to verify whether information from MDCT reconstruction of the airway is useful in airway management planning of children with MPS.
Methods:
In a two phase questionnaire-based study, 26 pediatric anesthesiologists were asked to produce airway management plans for 5 children with MPS. An initial plan for airway control was reported after assessment of standard preoperative anesthetic charts. A subsequent airway strategy was then described after reviewing tracheal MDCT images of each patient.
Results:
MDCT images provided additional clinically-relevant information in 87% (95% CI: 79-92%) of the evaluations. Reduction of tracheal size was the most common finding provided by the MDCT images. After reviewing the MDCT images, anesthesiologists changed their primary airway device selection in 21% of the evaluations (P=0.01).
Conclusion:
Airway reconstruction using MDCT images from a previous CT scan may provide a useful assessment tool for preoperative airway evaluation and planning in MPS children.
Related Concept Videos
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:28Imaging Studies for Cardiovascular System V: CT