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The cricoid cartilage and the esophagus are not aligned in close to half of adult patients

[Le cartilage cricoïde et l'sophage ne sont pas alignés chez près de la moitié des adultes]

Kevin J. Smith, MD^*, Shayne Ladak, MD, Peter T.-L. Choi, MD, FRCPC^* and Julian Dobranowski, MD, FRCPC

^* From the Departments of Anesthesia and
Radiology, St. Joseph's Healthcare and McMaster University, Hamilton, Ontario, Canada.

Address correspondence to: Dr. Kevin Smith, Department of Anesthesia, McMaster University, 1200 Main Street West, Room HSC-2U1, Hamilton, Ontario L8N 3Z5, Canada. Phone: 905-521-2100, ext. 75170; Fax: 905-523-1224; E-mail: kevjo{at}sympatico.ca

Purpose: To determine the frequency and degree of lateral displacement of the esophagus relative to the cricoid cartilage ("cricoid") using computed tomography (CT) images of normal necks.

Methods: Fifty-one cervical CT scans of clinically normal patients were reviewed retrospectively. Esophageal diameter, distance between the midline of the cricoid and the midline of the esophagus, and distance between the lateral border of the cricoid and the lateral border of the esophagus were measured.

Results: Lateral esophageal displacement was observed in 49% (25/51) of CT images. When present, the mean length of displaced esophagus relative to the midline of the cricoid was 3.3 mm ± SD 1.3 mm. Of those with lateral displacement, 64% had esophageal displacement beyond the lateral border of the cricoid (mean 3.2 mm ± SD 1.2 mm). There is a relatively normal distribution of the grouped measures of percentage of esophageal diameter that is displaced. Of those with displacement, 48% had over 15% of the total width of the esophagus displaced laterally and 20% had over 20% of the esophageal width displaced laterally.

Conclusion: There is a 49% frequency of some degree of lateral displacement of the esophagus relative to the cricoid.

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