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Pediatric laryngeal dimensions: an age-based analysis

Priti G Dalal1, David Murray, Anna H Messner

  • 1Department of Anesthesiology, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania 17033, USA. pdalal@hmc.psu.ed

Anesthesia and Analgesia
|April 18, 2009
PubMed

Insights

In children, the glottis is the narrowest airway section, not the cricoid. Pediatric airways are more cylindrical than funnel-shaped, similar to adults, based on video bronchoscopy measurements.

Area of Science:

  • Pediatric Otolaryngology
  • Airway Imaging
  • Pediatric Anesthesia

Background:

  • The pediatric airway transitions from funnel-shaped to cylindrical during growth.
  • Clinical decisions in pediatric airway management often rely on understanding this airway transition.
  • The narrowest point of the pediatric airway is typically considered the cricoid cartilage.

Purpose of the Study:

  • To measure laryngeal dimensions in children across various age groups.
  • To determine if video bronchoscopy can identify the transition from a funnel-shaped to a cylindrical airway.
  • To compare the dimensions of the glottis and cricoid regions.

Main Methods:

  • Video bronchoscopy was used to measure laryngeal dimensions in 135 children (6 months to 13 years).
  • Measurements included cross-sectional area (CSA) at the glottis (G-CSA) and cricoid (C-CSA).
  • Children were classified as ASA physical status 1 or 2 and underwent general anesthesia.

Main Results:

  • The glottis (G-CSA) was narrower than the cricoid (C-CSA) in children (30 mm² vs. 48.9 mm²).
  • This finding (G-CSA < C-CSA) was consistent from 6 months of age.
  • Airway dimensions showed positive correlations with age, height, and weight, with no significant gender differences.

Conclusions:

  • The glottis, not the cricoid, is the narrowest part of the pediatric airway.
  • Pediatric airways appear more cylindrical than funnel-shaped, aligning with adult airway characteristics.
  • Further research is needed to correlate static measurements with dynamic airway function in children.
Abstract

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