chapter  51
1 Pages


In medico-legal terms the principal issue surrounding these rare but dangerous conditions is centred on their prompt diagnosis and the management of associated, potentially lethal obstruction to the breathing. The operation of tracheostomy is often required and may present technical difficulty in very small necks. Giving a general anaesthetic to an infant with upper airway obstruction is fraught with danger, not only because of the much smaller size of the infantile larynx, through which a tube is usually passed initially to secure the airway while the surgeon works, but also because of the anatomical abnormalities involved in these particular cases, which may render intubation of the windpipe by the anaesthetist difficult or impossible.