Prevertebral Soft Tissue Thickness among Pediatric Patients

Abstract

Objective: This study aimed to determine the prevertebral soft tissue thickness among normal patients aged 0-14 years old in a tertiary government training hospital, to compare these values with divergent criteria in the standard otorhinolaryngology and radiology texts used in our institution, and to recommend adoption of a set of criteria based on the results. 
 Methods
 Study Design: Descriptive Study
 Setting: Tertiary Government Hospital 
 Subjects and Methods: Lateral cervical radiographs taken from May 2007 to August 2009 which were initially read as normal were collected. Fifty (50) patients, 39 males and 11 females, aged 0-14 years old meeting inclusion criteria were reviewed and prevertebral soft tissue thicknesses (PVST) and cervical vertebral body diameter at levels C2, C5, C6 were measured and compared to criteria set by standard otorhinolaryngology and radiology textbooks. 
 Results: The average PVST at C2 ranged from 4.02 mm for 2–3 year-olds (n= 2) to 8.16 mm for 1 –2 year-olds (n=2). The average PVST at C5 ranged from 8.11mm for 1–2 year-olds to 10.75 mm for for 0-1 year-olds. The average PVST at C6 ranged from 7.13 mm for 1 – 2 year-olds to 10.36 mm for 0-1 year-olds. Only 12% of the patients satisfied the criteria set by Keats and Lusted, while 100% satisfied Duncan’s criteria, 94% and 98% satisfied Wippold’s 1st and 2nd criteria respectively. 
 Conclusion: All of the PVST criteria mentioned in Cummings’ Textbook of Otorhinolaryngology Head and Neck Surgery had a more than 90% accuracy compared to only 12% for those mentioned in Keats and Lusted’s Atlas of Roentgenographic Measurement. Therefore, we recommend the use of any criteria for PVST contained in the former over the latter. 
 Keywords: Prevertebral soft tissue thickness, cervical vertebra