What is the vallecula sign used in the diagnosis of epiglottitis?

Updated: Apr 28, 2020
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Another useful tool in differentiating epiglottitis is to examine the vallecula (pre-epiglottic space). To locate the vallecula, use a soft-tissue lateral neck radiograph taken while the patient's mouth is closed. The vallecula is the air pocket found at the level of the hyoid bone just anterior to the epiglottis. The vallecula is normally well delineated, deep, and roughly perpendicular to the pharyngotracheal air column. The "vallecula sign of epiglottitis" is present when the normal deep linear air space from the tongue base almost to the epiglottis is made shallow or obliterated. Instead of a deep linear space, a V-shaped shallow space is seen. [22]

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