{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T11:42:59Z","timestamp":1782819779878,"version":"3.54.5"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,7,16]],"date-time":"2013-07-16T00:00:00Z","timestamp":1373932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2013,8]]},"abstract":"ABSTRACT<\/jats:title>Objectives<\/jats:title>To present a systematic approach for evaluating the fetal pharynx and larynx based on two\u2010 and three\u2010dimensional ultrasound (2D\u2010US<\/jats:styled-content> and 3D\u2010US<\/jats:styled-content>) modalities, describing the sonographic appearance and function of the fetal upper respiratory tract and measuring the anatomical components of the pharynx and larynx.<\/jats:p><\/jats:sec>Methods<\/jats:title>Gravidae presenting from the late first trimester to mid\u2010gestation for routine booked examinations with structurally normal singleton fetuses of confirmed gestational age were enrolled. Transabdominal 2D\u2010US<\/jats:styled-content> was performed for anatomical and functional evaluation of the pharynx and larynx. Color Doppler was used to show fluid motion in the target area. 3D\u2010US<\/jats:styled-content> (Voluson\u00ae E6<\/jats:styled-content> with RAB<\/jats:styled-content>\u20104\u20108\u2010D transducer) scans of the fetal neck were acquired during fetal quiescence and in the absence of movements of the pharynx and larynx. Multiplanar reconstruction (MPR<\/jats:styled-content>) in post\u2010processing allowed adjustment of the volume to obtain the coronal plane. After a learning period to understand the sonographic anatomy of the target area, we measured the pharynx width and height, the upper, middle and lower larynx width and the larynx height. Render mode was applied for spatial evaluation of the target area. We developed a new methodological approach for structured evaluation of the fetal pharynx and larynx based on five spatial planes: posterior and anterior coronal planes and high, mid and low axial planes.<\/jats:p><\/jats:sec>Results<\/jats:title>We examined 582 fetuses during the second trimester of pregnancy; target anatomy was imaged successfully in 218 patients at 11\u201324 gestational weeks. Acquisition added approximately 1 min to examination time. Rates of successful visualization and measurements increased significantly as pregnancy progressed, being 23% (46\/194) at 11\u201313 weeks, 29% (69\/240) at 14\u201316 weeks, 35% (18\/51) at 17\u201319 weeks and 88% (85\/97) at 20\u201324 weeks (P<\/jats:italic>\u2009<\u20090.01). Pharynx components identified were: the sphenoid bone, pterygoid processes, constrictor muscles, piriform recesses and uvula. Larynx components identified were: the epiglottis, aryepiglottic folds, corniculate cartilages, arytenoid cartilages, cricoid cartilage, thyroid cartilage and vocal cords. MPR<\/jats:styled-content> showed the biconcave shape of the uvula, which may explain the \u2018equals sign\u2019 observed on 2D\u2010US<\/jats:styled-content>. We observed the bilateral mode of movements of the constrictor muscles, aryepiglottic folds and vocal cords, and the bidirectional fluid jet flows through the larynx. Scatterplots of measured structures vs gestational age were created. Pharynx width ranged from 0.11 to 0.93\n(mean\u2009\u00b1\u2009SD<\/jats:styled-content>, 0.48\u2009\u00b1\u20090.17) cm; pharynx height ranged from 0.23 to 2.01 (mean\u2009\u00b1\u2009SD<\/jats:styled-content>, 0.94\u2009\u00b1\u20090.34) cm; upper larynx width ranged from 0.04 to 0.37 (mean\u2009\u00b1\u2009SD<\/jats:styled-content>, 0.15\u2009\u00b1\u20090.07) cm; middle larynx width ranged from 0.08 to 0.77 (mean\u2009\u00b1\u2009SD<\/jats:styled-content>, 0.34\u2009\u00b1\u20090.16) cm; lower larynx width ranged from 0.05 to 0.64 (mean\u2009\u00b1\u2009SD<\/jats:styled-content>, 0.24\u2009\u00b1\u20090.11) cm; and larynx height ranged from 0.20 to 1.83 (mean\u2009\u00b1\u2009SD<\/jats:styled-content>, 0.71\u2009\u00b1\u20090.31) cm. All measurements were positively correlated with gestational age.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The fetal larynx and pharynx can be evaluated thoroughly using 2D<\/jats:styled-content>\u2010 and 3D\u2010US<\/jats:styled-content> modalities. Knowledge of normal anatomy, function and biometry may prove useful in the evaluation of anatomical or functional pathology involving the fetal upper respiratory tract. Recognition of anatomical anomalies may enhance fetal intervention such as balloon placement in cases of diaphragmatic hernia. Copyright \u00a9 2012 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.12358","type":"journal-article","created":{"date-parts":[[2012,12,13]],"date-time":"2012-12-13T12:23:48Z","timestamp":1355401428000},"page":"140-148","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["The fetal larynx and pharynx: structure and development on two\u2010 and three\u2010dimensional ultrasound"],"prefix":"10.1002","volume":"42","author":[{"given":"G.","family":"Liberty","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Barzilai Medical Center Ashkelon Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Boldes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Bikur Holim Hospital Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Shaare Zedek Medical Center Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Shaul","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Shaare Zedek Medical Center Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hadassah\u2010Hebrew University Medical Centers Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Yagel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hadassah\u2010Hebrew University Medical Centers Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,7,16]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"863","volume-title":"Clinical Anatomy for Medical Students","author":"Snell RS","year":"1992"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ar.1092270312"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1985.4.7.343"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2005.05.002"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1994.04010021.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199903)19:3<211::AID-PD487>3.0.CO;2-9"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0b013e328329243c"},{"key":"e_1_2_5_9_1","first-page":"2577","volume-title":"Cummings Otolaryngology Head and Neck Surgery","author":"Graney DO","year":"2012"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7704"},{"key":"e_1_2_5_11_1","first-page":"277","volume-title":"Essential Otolaryngology","year":"2008"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-008-0962-2"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2008.04.011"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0378-3782(95)01721-6"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0709(00)80120-9"},{"key":"e_1_2_5_16_1","first-page":"776","volume-title":"Essential Otolaryngology","author":"Sie KCY","year":"2008"}],"container-title":["Ultrasound in Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.12358","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.12358","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T05:55:09Z","timestamp":1696485309000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.12358"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,7,16]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2013,8]]}},"alternative-id":["10.1002\/uog.12358"],"URL":"https:\/\/doi.org\/10.1002\/uog.12358","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7,16]]},"assertion":[{"value":"2012-11-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-07-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}