Tiny airway, big challenges: A case series on paediatric difficult airway

Paediatric difficult airway is a major problem because failed ventilation or intubation can rapidly cause hypoxaemia. We report six paediatric patients with anticipated difficult airway due to frontal dermoid cyst, macroglossia, occipital encephalocele, cleft lip and palate, post-burn neck contracture and temporomandibular joint ankylosis. Each case was managed with a separate airway plan using modified mask ventilation, conventional laryngoscopy, bimanual laryngoscopy with bougie, videolaryngoscopy, contracture release under ketamine sedation or fibreoptic nasotracheal intubation. All patients were managed successfully without major airway related complication, showing the value of careful assessment, preparation and individualised airway strategy.