Prevention of accidental childhood strangulation: where is the site of obstruction?

Background: Accidental strangulation is a preventable problem with limited scientific understanding in children. Children's clothing and household fur niture have the potential to cause strangulation. Localizing the site of ob struction would provide understanding and insight to preventing this unfort unate event, Methods: While undergoing the application of pressure to the s ubmental and suprahyoid region in eight patients flexible endoscopy was per formed to evaluate the location of obstruction. Results: Submental pressure occluded the nasopharynx and oropharynx. Suprahyoid pressure occluded the larynx. Conclusions: In suspension strangulation, airway obstruction appear s to occur at the level of the larynx involving the epiglottis and the aryt enoids. Increased knowledge regarding site of airway occlusion may help to decrease the hazard of accidental strangulation. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.