Modified technique of high-resolution ultrasonography of the normal cervical esophagus

Background and Aim: To study a modified technique of neck ultrasound for the visualization of cervical esophagus using a high-resolution and high frequency linear transducer in normal subjects. Methods: Consecutive control subjects were patients who underwent abdominal sonography for other diseases and had no past or current history of dysphagia or esophageal disorders. The thyroid gland was used as a transducer window to obtain images. We used a slightly flexed neck position with the head turned 45 degrees to the opposite side while scanning the neck on either side. Results: One-hundred subjects were scanned and their age range was 10-74 years (male : female ratio 1:1). In 36% of cases it was difficult to visualize the right lateral 2/3rd in the traditional scanning position of the neck. This improved to 2% with the modified neck position. All patients had the left window visualized with both neck positions. The transverse diameter, anterior-posterior diameter and wall thickness measures were all significantly greater with the modified technique. All patients tolerated the procedure with no reported discomfort. Conclusions: This modified technique provides superior views of the cervical esophagus, particularly from the right window, in almost all patients. Normal parameters using ultrasound have now been established.