{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:31:12Z","timestamp":1747150272694,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T00:00:00Z","timestamp":1538524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Nemours Summer Scholar Program"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The Small Parts Test Fixture (SPTF) (16 CFR 1501) was developed from cadavers of young children and foreign body (FB) data. Recent FB studies reveal that the SPTF misses outliers. Computerized tomography (CT) provides detailed dimensional data for young children. Our null hypothesis is that the SPTF (31.75\u2009mm) is smaller than relevant portions of the aerodigestive tract.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 3\u2010year retrospective review (2011\u20132014) of head\/neck CT data for infants and children (N\u2009=\u2009106) aged 6 months to 6 years was completed. Six measurements (mm) were recorded: 1) maxillary incisors to posterior edge of hard palate (MI\/HP); 2) posterior edge of hard palate to first cervical (C1) vertebra (HP\/C1); 3) soft palate to posterior pharyngeal wall; and 4) interpalatine tonsillar distance; 5, 6) larynx diameter, and width. Two ratios were calculated: 1) ratio of lengths (hard palate to soft palate), and 2) laryngeal dimensional ratio.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A linear trend of increasing dimensions with increased age was noted. The length measured MI\/HP best correlates with known data of potential FBs causing injury or death. This MI\/HP length can range from 33.8 to 45.8\u2009mm for all children younger than 3 years of age and exceeds the SPTF diameter (31.75\u2009mm). There were no statistical anatomical differences by gender in any of the age groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Computed tomography measurements appear larger than SPTF values developed from cadavers. These CT data support enlargement of the SPTF to enhance safety for choking hazards in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4<\/jats:p><jats:p><jats:italic>Laryngoscope<\/jats:italic>, 129:1468\u20131476, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27354","type":"journal-article","created":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T19:26:03Z","timestamp":1538767563000},"page":"1468-1476","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Computerized Tomography Analysis of Young Children for Prevention of Aspiration Injuries"],"prefix":"10.1002","volume":"129","author":[{"given":"Nicholas M.","family":"Milkovich","sequence":"first","affiliation":[{"name":"University of Virginia College of Engineering  Charlottesville Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott M.","family":"Milkovich","sequence":"additional","affiliation":[{"name":"Neoteric Engineering LLC  Glen Ellyn Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary P.","family":"Harty","sequence":"additional","affiliation":[{"name":"the Department of Medical Imaging  Wilmington Delaware"},{"name":"the Department of Radiology  at Thomas Jefferson University  Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi H.","family":"Kecskemethy","sequence":"additional","affiliation":[{"name":"the Department of Medical Imaging  Wilmington Delaware"},{"name":"the Department of Biomedical Research  Nemours\/Alfred I. duPont Hospital for Children  Wilmington Delaware"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenna W.","family":"Briddell","sequence":"additional","affiliation":[{"name":"the Department of Surgery (Otolaryngology)  Wilmington Delaware"},{"name":"the Department of Otolaryngology\u2013Head and Neck Surgery  Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica R.","family":"Levi","sequence":"additional","affiliation":[{"name":"University of Virginia College of Engineering  Charlottesville Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0843-2644","authenticated-orcid":false,"given":"James S.","family":"Reilly","sequence":"additional","affiliation":[{"name":"the Department of Surgery (Otolaryngology)  Wilmington Delaware"},{"name":"the Department of Otolaryngology\u2013Head and Neck Surgery  Philadelphia Pennsylvania"},{"name":"Department of Otolaryngology Boston University Medical Center  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1001\/jama.1980.03310120031018","article-title":"Childhood asphyxiation by choking and suffocation","volume":"224","author":"Baker SP","year":"1980","journal-title":"JAMA"},{"key":"e_1_2_6_3_1","unstructured":"Federal Register Notice: Banning of toys and other children's articles presenting choking aspiration and\/or ingestion hazards due to small parts: 22 January 1973; 38:14 21 CFR Pt. 191."},{"key":"e_1_2_6_4_1","unstructured":"VanHoutenDT.Human Factors Analysis of Ingestion Aspiration and Choking Injuries. U. S. Consumer Product Safety Commission Report June 5 1978."},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949009900404"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949210100904"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0196-0709(95)90101-9"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(05)70525-3"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199701000-00006"},{"key":"e_1_2_6_10_1","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1001\/jama.1995.03530220029027","article-title":"Characteristics of objects that cause choking in children","volume":"274","author":"Rimell FL","year":"1995","journal-title":"JAMA"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31818173d5"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.27354","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.27354","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.27354","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.27354","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T13:23:56Z","timestamp":1694352236000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.27354"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,3]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1002\/lary.27354"],"URL":"https:\/\/doi.org\/10.1002\/lary.27354","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"type":"print","value":"0023-852X"},{"type":"electronic","value":"1531-4995"}],"subject":[],"published":{"date-parts":[[2018,10,3]]},"assertion":[{"value":"2018-05-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}