Judith M. Czaja, MD, Thomas V. McCaffrey, MD, PhD

A device that determines cross-sectional area (CSA) of the airway by acoustic reflections (Hood, Inc) was used to measure subglottic area. Airway models were made from Plexiglas rings with known internal dimensions similar to clinically encountered stenoses of various lengths and diameters. Acoustic measurements of airway area were made and compared to actual CSA. There is a strong correlation between CSA measured acoustically and the actual area of simulated stenoses. However, when the CSA of the stenosis was <0.64 sq. cm., the signal was impaired, resulting in overestimation of the stenotic CSA. In simulated stenoses with a CSA of <0.38 sq. cm., acoustic measurement of the CSA beyond the stenotic segment was unreliable. Determination of the origin of stenosis was accurate with this method. The CSA of cadaver airways was also measured acoustically. The CSA 2.0 cm below the glottis of normal airways in males ranged from 1.28 to 2.74 sq. cm. and in females 0.87 to 1.43 sq. cm., with means of 2.16 and 1.09 sq. cm.. It appears that acoustic measurement of CSA of subglottic stenosis is a feasible clinical technique that yields dimensions of the airway in situations in which direct measurements are impossible. It was suggested that this technique be used for assessment of subglottic stenosis and evaluation of the efficacy of treatment of subglottic stenosis.