Computerized Tomography Analysis of Young Children for Prevention of Aspiration Injuries

Nicholas M Milkovich1, Scott M Milkovich2, Mary P Harty3,4

  • 1University of Virginia College of Engineering, Charlottesville, Virginia.

The Laryngoscope
|October 5, 2018
PubMed

Insights

The Small Parts Test Fixture (SPTF) is smaller than the aerodigestive tract dimensions in young children. CT scans reveal that the SPTF may miss some choking hazards, suggesting a need for enlargement.

Area of Science:

  • Pediatric Safety
  • Medical Device Standards
  • Anatomical Measurement

Background:

  • The Small Parts Test Fixture (SPTF) is used to assess choking hazards in children.
  • Recent studies indicate the SPTF may not accurately represent all potential foreign body (FB) sizes.
  • Computed tomography (CT) offers detailed anatomical data for pediatric populations.

Purpose of the Study:

  • To compare the dimensions of the pediatric aerodigestive tract with the Small Parts Test Fixture (SPTF).
  • To determine if the SPTF adequately captures the size of potential choking hazards in young children.
  • To provide data supporting potential modifications to the SPTF for improved child safety.

Main Methods:

  • Retrospective review of head/neck CT scans from 106 infants and children (6 months to 6 years).
  • Measurement of key aerodigestive tract dimensions, including maxillary incisors to hard palate (MI/HP) and larynx diameter.
  • Calculation of specific anatomical ratios to assess dimensional variations.

Main Results:

  • A linear trend of increasing dimensions with age was observed in pediatric anatomy.
  • The MI/HP length (33.8–45.8 mm) in children under 3 years exceeded the SPTF diameter (31.75 mm).
  • No significant gender-based anatomical differences were found across age groups.

Conclusions:

  • CT-derived measurements of the pediatric aerodigestive tract are larger than SPTF dimensions.
  • The current SPTF may underestimate choking hazards for young children.
  • Enlargement of the SPTF is recommended to enhance safety standards for pediatric choking hazards.
Abstract

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