This was taken in the ER and report read as "normal" was sent to my ENT, Dr. Mucci, who, in turn, assumed it was normal.    I thought the airway looked narrow in the exact place where my tongue pulls back obstructing the airway. (indicated with arrows). I brought the film to Dr. Mucci, who confirmed my impression.  From his report of  4-21-04: She also had a lateral soft tissue projection of  the neck done and brings that with her today. She pointed out to me that the tongue base appears retrodisplaced; in my view,  it does appear the base of tongue is closer to the posterior oropharynx than the average patient.

I also posted the image to AuntMinnie.com, a radiology forum, and received the following opinion from an experienced radiologist. 

["As preamble, doctors like other professionals, are to a large extent pattern readers, which means that they recognize most readily what they already understand & are familiar with and that conversely they are much more likely to miss something they have never seen or which makes them uncomfortable.
I agree that there is narrowing of the airway where you have placed the arrows.  The tongue seems humped up posteriorly (toward the rear) and pulled into the airway, producing narrowing. Obviously, my familiarity with your history & the results of the MBS made my observations pretty easy.  In all fairness, radiologists are not often presented with such studies as your particular C-Spine & the tongue in this region is not often a point of interest.   I can only pray that I am having a good day if I see the next study such as yours."]

Another radiologist said the position of the tongue is normal; that my tongue "just happened" to be in that position because I must have swallowed when the film was taken.   It is impossible for me to swallow with my head in an upright position.  I simply cannot do it, as the MBS proves.  The x-ray tech asked me to keep my head in the position that causes the problematic breathing.  Therefore, this image accurately represents my airway with my head in a neutral posture.

 

Cape Cod Hospital

10-20-2003

NECK SOFT TISSUES:

 Lateral soft tissue views of the neck. The anterior and posterior vertebral body alignment appear unremarkable. There is moderate C5-6 and to a lesser extent C4-5 intervertebral disc space narrowing. There is moderate degenerative disease involving the facet joints of the cervical spine at levels C3 through 7. There is no evidence of prevertebral soft tissue swelling. The epiglottis appears unremarkable. There is no evidence of abnormality of the base of the tongue. Patient has missing teeth and multiple dental restorations.

IMPRESSION: No soft tissue abnormality. Moderate C5-6 and to a lesser extent C4-5 intervertebral disc space narrowing and associated degenerative disease.

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