• A D Farmery, D Shlugman, and P Anslow.
• Neurointensive Care Unit and Department of Neuroradiology, Radcliffe Infirmary Woodstock Road, Oxford OX2 6HE, UK. andrew.farmery@nda.ox.ac.uk
• Br J Anaesth. 2003 Apr 1; 90 (4): 452-6.

BackgroundThe relationship between the larynx and the subclavian arteries was studied in a series of magnetic resonance images (MRIs) from 50 patients without neck pathology.MethodsThe vertical distances of the excursion of the subclavian arteries into the neck was measured, as was the distance from the cricoid cartilage to the highest point of this excursion. Statistical analysis allows the probability of any given cricoid-subclavian distance occurring in the population to be estimated.ResultsThe mean (SD) excursion of the right subclavian artery above the clavicle was 10.4 (11.4) mm. The mean (SD) distance from the cricoid cartilage to the right subclavian artery was 30.6 (14.3) mm, and the data showed a high degree of variance. There was a linear relationship between neck length and cricoid-subclavian distance (r=0.58), which explained some of the variance in the latter, but there was also wide individual variance, which was independent of this regression.ConclusionsWhen performing a percutaneous tracheostomy, a 'safe' distance between the incision site and subclavian artery cannot be assumed or reliably predicted from the neck length.

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