Difficult airway management of children in ambulatory anesthesia: challenges and solutions

Figures & data

Table 1 Congenital difficult airway – syndromes

Syndrome	Airway features
Apert syndrome	Midface hypoplasia; possible choanal stenosis; progressive calcification of cervical spine
Crouzon syndrome Pfeiffer syndrome Pierre Robin sequence	Midface hypoplasia; maxillary hypoplasia Midface hypoplasia Micrognathia; glossoptosis (backward displacement of tongue); cleft palate
Goldenhar syndrome	Asymmetrical malar; maxillary and mandibulary hypoplasia; hemifacial microsomia
Treacher Collins syndrome	Bilateral malar and mandibular hypoplasia; airway obstruction at rest
Mucopolysaccaridoses (Hunter’s and Hurler’s syndrome)	Accumulation of mucopolysaccharides in various tissues, including airway; short, immobile neck; cervical instability
Beckwith–Wiedemann syndrome	Macroglossia

Figure 1 Suggested algorithm to aid in decision of whether a pediatric patient with a difficult airway should proceed with ambulatory surgery.

Abbreviations: CPAP, continuous positive airway pressure; BiPAP, bilevel positive airway pressure; HNFC, high flow nasal cannula.