Developmental anatomy of the airway

Abstract 

The airway develops from the primitive foregut and a number of congenital anomalies may result when this process is abnormal. The anatomy of the neonatal airway is significantly different from older children and adults. The larynx is cephalad, the epiglottis large and the cricoid cartilage is the narrowest part of the upper airway. The technique of endotracheal intubation is significantly different in neonates compared with older children and adults. A straight-bladed laryngoscope and an uncuffed endotracheal tube are usually used. During the first years of life the anatomy gradually becomes more like that of adults. By the age of 8–10 years normal children have an airway that is anatomically adult in most ways other than absolute size. The technique used for endotracheal intubation in adults is appropriate, including the use of a Macintosh laryngoscope blade and a cuffed endotracheal tube.

Keywords: endotracheal tube, epiglottis, paediatric airway