Hello, I'm Dr. Gordon Bell. Today I'm going to demonstrate a method to consistently and accurately measure neck circumference. Neck circumference is an important measurement to use when screening for sleep disordered breathing. It is also an important baseline measurement for all patients being treated with oral appliance therapy. Measurements of greater than 17 inches in men and 15 inches in women are associated with a greater risk for obstructive sleep apnea. Measuring neck circumference is both simple and easily implemented by all staff members. It is important to standardize the process of measuring neck circumference in a dental clinic so it is not only accurate and reproducible, but also so it can be monitored for changes over time. Now, let's get started. First, I will instruct my patient to sit upright in the dental chair. If you would, Elvis, sit up nice and straight, not against the headrest. I don't want the patient to either tip their head back into the headrest, nor tuck their chin downward. Their head should be upright and focused forward. So just nice straight posture, good upright head position. That's perfect. We like that. When I palpate the patient's anterior neck, I will identify the thyroid cartilage with the notch at the top and obvious laryngeal prominence. Immediately superior to the thyroid cartilage is the hyoid bone. Immediately inferior to thyroid cartilage is the cricoid cartilage with a palpable horizontal depression between it and the thyroid cartilage. I want to align my measuring tape horizontally just below the thyroid notch and laryngeal prominence and just above the cricoid cartilage. It's often easier to identify the anatomical structures if we ask the patient to tip their head back. So if you would really stretch your neck out, tip it back for me. I can palpate the hyoid bone just beneath the mandible using my index finger and thumb. It will generally move slightly side to side. Using a finger, I can palpate the laryngeal prominence, the top of which is the thyroid notch. When I slide downward slightly, I can feel a slight horizontal depression. This is the ligamentous space between the thyroid cartilage and the cricoid cartilage. Before I position the tape, I'll ask my patient to go back to the correct head posture. I'll position my tape just beneath the thyroid notch and laryngeal prominence. We're using here just a simple expanding tape. I'm measuring 18 1⁄2 inches on this patient. Since that is greater than 17 inches, I would want to start a conversation with this patient to explore my suspicion of sleep-related breathing disorders. Any staff member can be trained to record an accurate neck circumference. As staff members are becoming familiar with this process, it is valuable to verify their measurements to ensure accuracy and reproducibility. This is important objective data for your records and will be instrumental in building positive relationships with your patient's physicians. I hope you enjoyed this presentation and found it helpful. Thank you very much for watching.

neck circumference

measurement

sleep-disordered breathing

obstructive sleep apnea

anatomical landmarks