Providing anesthesia for otolaryngology procedures can present a variety of challenges and considerations. The wide range of procedures continues to expand as surgical equipment and techniques evolve. Many of these procedures involve the airway in some capacity, and thus require the anesthesia provider to have a clear understanding of each facet of the surgical plan, as well as maintain constant communication with the surgeon to safely share the airway. This section will outline some of the considerations for commonly performed surgeries of the ear, nose, and throat in children. Airway procedures Anatomy and physiology It is imperative to have a thorough understanding of pediatric airway anatomy and physiology in order to provide safe anesthetic care during airway procedures. Distinctions in pediatric airway anatomy include, but are not limited to: a large tongue, long and narrow epiglottis, and a high larynx. In addition, the narrowest part of the airway in pediatric patients is the cricoid ring, as opposed to the glottic inlet in adults. The cricothyroid membrane is comparatively short, making emergent urgent needle cricothyroidotomy more challenging.
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