The pediatric airway

McNiece, William L.; Dierdorf, Stephen F.

doi:10.1053/j.sempedsurg.2004.04.008

Cited by 26 publications

(15 citation statements)

References 78 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If these methods are unsuccessful, the laryngeal mask airway (LMA) is the next step to secure the patency of the airway. Fiberoptic tracheal intubation can be performed through a LMA, and some authors have reported the usefulness of LMA for maintaining airway patency in patients with TCS [2,5]. On the other hand, Sophie et al reported the usefulness of GlideScope for tracheal intubation in patient with TCS [6].…”

Section: Discussionmentioning

confidence: 99%

Airway Management for Treacher Collins Syndrome with Limited Mouth Opening

Sato

Hanamoto

Kudo

et al. 2013

OJAnes

View full text Add to dashboard Cite

Patients with Treacher Collins Syndrome (TCS) present unique airway management problems for anesthesiologists due to mandibular micrognathia, the small oral aperture, and temporomandibular joint anomalies. We describe the case of a pediatric TCS patient with limited mouth opening who experienced severe airway obstruction during deep inhalation anesthesia (sevoflurane following i.v. midazolam) for routine dental work. When difficult airway management is expected, intubation of conscious patients is a well-recognized technique in adults; however, it is rarely appropriate for pediatric patients who usually do not cooperate. According to general anesthesia algorithms for pediatric patients with difficult airways, in most pediatric patients, tracheal intubation is performed after the induction of general anesthesia and some authors have reported the usefulness of LMA for maintaining airway patency in patients with TCS. However, in our case LMA could not be used because of severe limitation of mouth opening. In addition, the LMA is so bulky that it is impossible to insert a LMA into patients with narrow airway anatomy. We initially planned to carry out fiberoptic intubation while awake and under sedation if the airway patency could not be secured after the induction of anesthesia. The patient was sedated properly with midazolam and sevoflurane, and awake fiberoptic intubation was performed uneventfully. Our experience in this case highlighted that careful planning of backup contingencies is important in achieving fiberoptic intubation and maintaining airway patency in pediatric TCS patients with limited mouth opening, and that awake intubation can be successful even in pediatric patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Airway Management for Treacher Collins Syndrome with Limited Mouth Opening

Sato

Hanamoto

Kudo

et al. 2013

OJAnes

View full text Add to dashboard Cite

show abstract

“…Stridor is the sound produced by turbulent air fl ow in a partially obstructed trachea because of either intrinsic obstruction or extrinsic compression. Careful assessment of the time in the respiratory cycle in which stridor predominates may provide valuable diagnostic clues in determining the site of airway obstruction [14,[19][20][21][22][23][24][25]. For example, partial obstruction of the extrathoracic, supraglottic airway usually manifests as inspiratory stridor (i.e., occurring during the initial phase of inspiration).…”

Section: Acute Airway Obstructionmentioning

confidence: 99%

“…The structural complexity of the upper airway refl ects its diverse functions, which include phonation, olfaction, humidifi cation and warming of inspired air, digestion, preservation of airway patency, and protection of the airways [8,9]. The pediatric airway is markedly different from the adult airway [10][11][12][13]. These differences are most dramatic in the infant's airway and become less important as the child grows-the upper airway assumes the characteristics of the adult airway by approximately 8 years of age.…”

Section: Developmental Anatomy and Physiology Of The Pediatric Airwaymentioning

confidence: 99%

See 1 more Smart Citation

Assessment and Management of the Pediatric Airway

Wheeler

Spaeth

Mehta

et al. 2008

Resuscitation and Stabilization of the Critically Ill Child

View full text Add to dashboard Cite

Anatomic features that differ between children and adults include (1) a proportionally larger head and occiput (relative to body size), causing neck fl exion and leading to potential airway obstruction when lying supine; (2) a relatively larger tongue, decreasing the size of the oral cavity; (3) decreased muscle tone, resulting in passive obstruction of the airway by the tongue; (4) a shorter, narrower, horizontally positioned, softer epiglottis; (5) cephalad and anterior position of the larynx; (6) shorter, smaller, narrower trachea; and (7) funnel-shaped versus cylindrical airway, such that the narrowest portion of the airway is located at the level of the cricoid cartilage (Figure 4.1).The fi rst and perhaps most obvious difference is that the pediatric airway is much smaller in diameter and shorter in length than the adult's. For example, the length of the trachea changes from approximately 4 cm in neonates to approximately 12 cm in adults, and the tracheal diameter varies from approximately 3 mm in the premature infant to approximately 25 mm in the adult [11,13]. According to Hagen-Poiseuille's law, the change in air fl ow resulting from a reduction in airway diameter is directly proportional to the airway radius elevated to the fourth power:

show abstract

“…Rather, it is an anticipated difficult airway with little or nil mouth opening [28,34]. Although literature does mention protocols for airway management in syndromic children, there is no mention of children with TMJ ankylosis [23,35]. Management requires sufficient expertise in handling difficult airway in the pediatric population.…”

Section: Review Of Methods Used For Securing Airwaymentioning

confidence: 99%

Management of Young Patients with Temporomandibular Joint Ankylosis—a Surgical and Anesthetic Challenge

et al. 2016

View full text Add to dashboard Cite

Temporomandibular joint ankylosis is a unique disease where fracture of the mandibular condyle or any other cause leading to ankylosis of the joint can lead to multiple problems if not detected and treated early. If affected in early years of life, it may cause facial dysmorphism, restricted mouth opening, and difficulty in eating, speech, and sleep. Early surgery and physiotherapy can restore the joint function to a great extent. Anesthetizing a pediatric patient with this disorder is a definite challenge which needs expertise in difficult airway management.

show abstract

The pediatric airway

Cited by 26 publications

References 78 publications

Airway Management for Treacher Collins Syndrome with Limited Mouth Opening

Airway Management for Treacher Collins Syndrome with Limited Mouth Opening

Assessment and Management of the Pediatric Airway

Management of Young Patients with Temporomandibular Joint Ankylosis—a Surgical and Anesthetic Challenge

Contact Info

Product

Resources

About