Focused review on management of the difficult paediatric airway

Huang, Andrea; Hajduk, John; Rim, Catherine M.; Coffield, Sarah; Jagannathan, Narasimhan

doi:10.4103/ija.ija_250_19

Cited by 54 publications

(24 citation statements)

References 45 publications

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“…Micrognathia induces posterior regression of the tongue and a small hyoid-mental space, potentially resulting in hypopharyngeal collapse 2 , 16 . It can also cause narrowing of the submandibular space, which can obstruct glottic visualization and produce a difficult airway during laryngoscopy because of an inability to accommodate the displaced tongue 21 . In patients with mandibular hypoplasia, airway obstruction develops at various levels—from oropharyngeal obstruction due to glossoptosis and compressed hyoid position to hypopharyngeal obstruction due to micrognathia.…”

Section: Discussionmentioning

confidence: 99%

Developmental features and predicting airway failure risk in critically ill children with mandibular hypoplasia using 3D computational tomographic analysis

Kim

Gwon

Ock

et al. 2021

Sci Rep

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In children with mandibular hypoplasia, airway management is challenging. However, detailed cephalometric assessment data for this population are sparse. The aim of this study was to find risk factors for predicting difficult airways in children with mandibular hypoplasia, and compare upper airway anatomical differences using three-dimensional computed tomography (3D CT) between children with mandibular hypoplasia and demographically matched healthy controls. There were significant discrepancies in relative tongue position (P < 0.01) and anterior distance of the hyoid bone (P < 0.01) between patients with mandibular hypoplasia and healthy controls. All mandibular measures were significantly different between the two groups, except for the height of the ramus of the mandible. After adjusting for age and sex, the anterior distance of hyoid bone and inferior pogonial angle were significantly associated with a difficult airway (P = 0.01 and P = 0.02). Quantitative analysis of upper airway structures revealed significant discrepancies, including relative tongue position, hyoid distance, and mandible measures between patients with mandibular hypoplasia and healthy controls. The anterior distance of the hyoid bone and inferior pogonial angle may be risk factors for a difficult airway in patients with mandibular hypoplasia.

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Section: Discussionmentioning

confidence: 99%

Developmental features and predicting airway failure risk in critically ill children with mandibular hypoplasia using 3D computational tomographic analysis

Kim

Gwon

Ock

et al. 2021

Sci Rep

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“…Recent literature highlights the successful use of Airtraq in paediatric difficult airway. [ 10 11 12 ] Iordinadu et al . compared POGO scoring assessed using airtraq with conventional laryngoscopy in nine paediatric patients with difficult airway and confirmed improvement in visualisation of the larynx and 100% success rate of intubation with airtraq in such patients.…”

Section: Discussionmentioning

confidence: 99%

Airway management with Airtraq in a neonate with Epignathus. A case report

et al. 2020

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Presence of intraoral pathology especially in neonates poses a great challenge during airway management. Epignathus is a rare form of teratoid tumour that arises from the oropharyngeal region. We hereby report a case of a 7-day-old neonate who presented with feeding difficulty secondary to swelling arising from the hard palate. Surgical excision was decided to overcome feeding difficulty and to enable the child to thrive better. In view of anticipated difficult airway, the child was induced with sevoflurane, maintaining spontaneous breathing and intubated with Airtraq optical laryngoscope size 0. The further intraoperative and postoperative period was uneventful.

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“…The presence of a difcult airway is a signicant patient related risk factor associated with increased perioperative morbidity and mortality. 7 The anaesthesiologists should have other options for airway control and it should be discussed well in advance with the other team 4 members. Although beroptic intubation is the gold standard for the management of difcult airway , it has its own limitations.…”

Section: Discussionmentioning

confidence: 99%

A Case Report- A Case of Right Sided Absent Maxilla With Anticipated Difficult Airway Posted for Perineal Urethroplaty

Cherian

Sathyasuba

2020

IJAR

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The key to success in patients with difficult airway is effective airway assessment and meticulous planning. Making use of simple and time-tested equipment and modifying these methods accordingly enable successful airway control avoiding perioperative morbidity and mortality . We report a case of 75 year old male with posterior urethral stricture planned for perineal urethroplasty with anticipated difficult airway. The airway was managed using video laryngoscopy and the procedure was uneventful with good postoperative recovery. This case report insists on making use of other conventional methods in the effective management of an anticipated difficult airway during a pandemic.

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Focused review on management of the difficult paediatric airway

Cited by 54 publications

References 45 publications

Developmental features and predicting airway failure risk in critically ill children with mandibular hypoplasia using 3D computational tomographic analysis

Developmental features and predicting airway failure risk in critically ill children with mandibular hypoplasia using 3D computational tomographic analysis

Airway management with Airtraq in a neonate with Epignathus. A case report

A Case Report- A Case of Right Sided Absent Maxilla With Anticipated Difficult Airway Posted for Perineal Urethroplaty

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