ABSTRACT
Difficult airway is a clinical situation in which a conventionally trained anesthesiologist experiences difficulty with mask ventilation (MV), difficulty with tracheal intubation, or both. The difficult airway has three components that may or may not coexist: difficult bag-MV, difficult laryngeal MV and difficult surgical airway. Patients with occipital encephalocele may have associated airway abnormalities such as micrognathia, cleft lip or palate, and pulmonary hypoplasia. Hydrocephalus is associated with craniosynostosis syndromes and mucopolysaccharidosis—one of the most difficult airways in pediatric patients. Difficult laryngoscopy is unusual in patients with midface hypoplasia—muscle relaxant can be safely given if able to MV with the help of oropharyngeal airway (OPA)/nasopharyngeal airway (NPA)/laryngeal mask airway (LMA). Can't ventilate, can't intubate (CVCI) indicates failed face MV and failed intubation. The traditional approach to the difficult pediatric airway is maintenance of spontaneous ventilation under inhalational anesthesia. The chapter discusses the airway management techniques for patients with cervical injury and their effect on spine immobilization.
