{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T15:20:03Z","timestamp":1759936803383,"version":"3.40.5"},"reference-count":37,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T00:00:00Z","timestamp":1620691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Define the length of the subglottis and trachea in children to predict a safe intubation depth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients &lt;18\u2009years undergoing rigid bronchoscopy from 2013 to 2020 were included. The carina and inferior borders of the cricoid and true vocal folds were marked on a bronchoscope and distances were measured. Patient age, weight, height, and chest height were recorded. Four styles of cuffed pediatric endotracheal tubes (ETT) were measured and potential positions of each cuff and tip were calculated within each trachea using five depth of intubation scenarios. Multivariate linear regression was performed to identify predictors of subglottic and tracheal length.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Measurements were obtained from 210 children (141 male, 69 female), mean (SD) age 3.21 (3.66) years. Patient height was the best predictor of subglottic length (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>: 0.418): <jats:italic>Length<\/jats:italic><jats:sub><jats:italic>sg<\/jats:italic><\/jats:sub> <jats:italic>(mm)\u2009=<\/jats:italic>\u00a00.058 <jats:italic>* height (cm)\u2009+<\/jats:italic>\u00a02.8<jats:italic>,<\/jats:italic> and tracheal length (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>: 0.733): <jats:italic>Length<\/jats:italic><jats:sub><jats:italic>t<\/jats:italic><\/jats:sub> <jats:italic>(mm)<\/jats:italic>\u00a0=\u00a00.485 * <jats:italic>height (cm)<\/jats:italic>\u2009+\u200921.3. None of the depth of intubation scenarios maintained a cuff\u2010free subglottis for all ETT styles investigated. A formula for depth of intubation: <jats:italic>Length<\/jats:italic><jats:sub><jats:italic>di<\/jats:italic><\/jats:sub> <jats:italic>(mm)\u2009=<\/jats:italic>\u00a00.06 <jats:italic>* height (cm)\u2009+<\/jats:italic>\u00a08.8 found that no ETT cuffs would be in the subglottis and all tips would be above the carina.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Current strategies for determining appropriate depth of intubation pose a high risk of subglottic ETT cuff placement. Placing the inferior border of the vocal cords 0.06 <jats:italic>* height (cm)\u2009+<\/jats:italic>\u00a08.8 from the superior border of the inflated ETT cuff may prevent subglottic cuff placement and endobronchial intubation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 132:S1\u2013S10, 2022<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29616","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T16:49:29Z","timestamp":1620751769000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Length of the Cricoid and Trachea in Children: Predicting Intubation Depth to Prevent Subglottic Stenosis"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8013-8530","authenticated-orcid":false,"given":"Evan Jon","family":"Propst","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Hospital for Sick Children University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonah Haskel","family":"Gorodensky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Hospital for Sick Children University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5196-6150","authenticated-orcid":false,"given":"Nikolaus Ernst","family":"Wolter","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Hospital for Sick Children University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_7_2_1","DOI":"10.1097\/ALN.0b013e318282cc8f"},{"doi-asserted-by":"publisher","key":"e_1_2_7_3_1","DOI":"10.1007\/s001340101105"},{"doi-asserted-by":"publisher","key":"e_1_2_7_4_1","DOI":"10.1097\/00000542-199703000-00015"},{"doi-asserted-by":"publisher","key":"e_1_2_7_5_1","DOI":"10.1111\/j.1651-2227.2007.00578.x"},{"doi-asserted-by":"publisher","key":"e_1_2_7_6_1","DOI":"10.2486\/indhealth.35.112"},{"doi-asserted-by":"publisher","key":"e_1_2_7_7_1","DOI":"10.1093\/bja\/aeh023"},{"doi-asserted-by":"publisher","key":"e_1_2_7_8_1","DOI":"10.1016\/j.ijporl.2016.03.016"},{"doi-asserted-by":"publisher","key":"e_1_2_7_9_1","DOI":"10.1046\/j.0003-2409.2001.02364.x"},{"doi-asserted-by":"publisher","key":"e_1_2_7_10_1","DOI":"10.4103\/0970-9185.105786"},{"doi-asserted-by":"publisher","key":"e_1_2_7_11_1","DOI":"10.1213\/01.ANE.0000087882.04234.11"},{"doi-asserted-by":"publisher","key":"e_1_2_7_12_1","DOI":"10.1097\/PEC.0000000000000755"},{"doi-asserted-by":"publisher","key":"e_1_2_7_13_1","DOI":"10.1111\/j.1460-9592.2009.03004.x"},{"key":"e_1_2_7_14_1","first-page":"52","article-title":"Pediatric cuffed endotracheal tubes: an evolution of care","volume":"11","author":"Taylor C","year":"2011","journal-title":"Ochsner J"},{"doi-asserted-by":"publisher","key":"e_1_2_7_15_1","DOI":"10.1093\/bja\/aeh294"},{"doi-asserted-by":"publisher","key":"e_1_2_7_16_1","DOI":"10.2214\/ajr.146.2.233"},{"doi-asserted-by":"publisher","key":"e_1_2_7_17_1","DOI":"10.1288\/00005537-198410000-00005"},{"doi-asserted-by":"publisher","key":"e_1_2_7_18_1","DOI":"10.1044\/jshr.2503.446"},{"doi-asserted-by":"publisher","key":"e_1_2_7_19_1","DOI":"10.1097\/00000539-199602000-00006"},{"doi-asserted-by":"publisher","key":"e_1_2_7_20_1","DOI":"10.1093\/bja\/aep290"},{"doi-asserted-by":"publisher","key":"e_1_2_7_21_1","DOI":"10.1111\/j.1460-9592.2005.01686.x"},{"doi-asserted-by":"publisher","key":"e_1_2_7_22_1","DOI":"10.1007\/BF03007939"},{"doi-asserted-by":"publisher","key":"e_1_2_7_23_1","DOI":"10.1213\/ANE.0b013e3182991d42"},{"doi-asserted-by":"publisher","key":"e_1_2_7_24_1","DOI":"10.1111\/pan.13832"},{"doi-asserted-by":"publisher","key":"e_1_2_7_25_1","DOI":"10.1016\/j.bja.2018.05.002"},{"doi-asserted-by":"publisher","key":"e_1_2_7_26_1","DOI":"10.1002\/ppul.24046"},{"doi-asserted-by":"publisher","key":"e_1_2_7_27_1","DOI":"10.1111\/pan.13665"},{"doi-asserted-by":"publisher","key":"e_1_2_7_28_1","DOI":"10.1177\/000348946707600507"},{"unstructured":"Clinical calculators [Merck Manual Professional Version Web site].2020. 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