From the Guidelines
A Computed Tomography (CT) scan of the neck is indicated for tracheostomy evaluation in specific cases, such as when there is suspicion of tracheal lesions or stenosis involving the subglottic trachea, or in cases of suspected or known malignancies of the neck 1.
Key Indications for CT Neck Scan
- Suspected tracheal lesions or stenosis involving the subglottic trachea
- Suspected or known malignancies of the neck
- Pre- or posttreatment assessment of tracheal lesions and stenosis
Important Considerations
- Combined neck and chest CT with IV contrast may be more appropriate than a standalone neck CT, as it provides a more comprehensive evaluation of the trachea and surrounding structures 1.
- Limited z-axis coverage of neck CT may risk exclusion of the full extent of tracheal disease, making combined neck and chest CT a preferable option 1.
- The decision to perform a CT neck scan should be based on individual patient needs and the specific clinical context, taking into account the potential benefits and limitations of the examination.
From the Research
Indications for CT Scan in Tracheostomy Evaluation
- A Computed Tomography (CT) scan of the neck can be indicated for tracheostomy evaluation to assess pretracheal anatomical relationships and guide tracheotomy procedures in a safe manner 2.
- CT scans can help identify predictors of nonstandard tracheostomy tubes, such as trachea-to-skin distance and endotracheal tube size 3.
- Three-dimensional spiral CT reconstructions can be used to detect tracheal tube-related complications, including wrong placement of the tube, perforation of the tracheal wall, and tracheal stenosis 4.
CT Scan Benefits in Tracheostomy Evaluation
- CT scans provide a non-invasive evaluation of the outer tracheal wall and tracheal lumen 4.
- CT image-based evidence can prepare junior practitioners with important pretracheal anatomical information, facilitating safer tracheotomy procedures 2.
- CT scans can help identify vascular morphologies and relationships in the pretracheal region, which is crucial for safe tracheotomy procedures 2.