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Emergency Radiology

E3331. Role of CT Imaging in Acute Upper Airway Obstruction in the Emergency Department

Jindal G1,  DUBEY P.2 1. Warren Alpert School of Medicine, Brown University, Providence, United States; 2. Columbia University Medical Center, New York, United States

Address correspondence to G. Jindal (gauravjindal11@gmail.com)

Background Information: Acute airway obstruction is a common presentation in the emergency department (ED). As imaging utilization in the ED continues to grow, a greater number of such patients get scanned prior to endoscopic evaluation. In this exhibit, we present a series of cases of upper airway obstruction highlighting imaging findings with clinical correlation.

Educational Goals/Teaching Points: We discuss relevant cross-sectional anatomy of the neck, review common causes of upper airway obstruction, and highlight imaging findings in various traumatic and nontraumatic neck conditions presenting with airway obstructive symptoms.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: The following cases will be presented: laryngeal trauma; infections, inflammation, noninfectious and noninflammatory causes, and neoplastic causes. Traumatic laryngeal injuries are an important cause of airway obstruction and may get overlooked in the presence of concomitant cervical spine or facial injuries. Common laryngeal injuries detected on imaging range from submucosal hematoma to cartilage fractures/dislocation and laryngeal rupture. Infectious causes include supraglottitis, acute epiglottitis, infected laryngocele, retropharyngeal, and prevertebral or parapharyngeal space abscesses compressing the airway. Inflammatory causes include angioedema. Noninfectious and noninflammatory causes include laryngeal amyloidosis and spontaneous laryngeal submucosal hemorrhage. Neoplastic causes include laryngeal cancer.

Conclusion: We present a series of cases illustrating the important role of imaging in diagnosing and detecting the causes of airway obstruction in patients presenting to the ED.