Paediatric larynx differs from an adult as it is placed higher and more anteriorly (at a vertebral level of C3-C4), and tubular in shape. Neonates and most young children are obligate nasal breather; meaning they're very much dependent of patent nasal airway to breath. The good point is the child can breathe and sucks milk at the same time, but have difficulty to breathe through the mouth whenever both nostrils become blocked. In addition, they have shorter trachea and neck which pose some difficulty in airway management for the anaesthetist. However, it higher location gives some protection from external trauma or injury. Tonsillar enlargement is common is this age group until they reach adolescent age. In many, removal of the tonsils need to be performed due to recurrent infections or obstructive apnoea syndrome (OSA). This video shows the throat of a 5 year old child with tonsillar enlargement on either sides. The epiglottis was visualized easily seen behind the hanging epiglottis. (E- epiglottis, U- uvula, T-tonsil, TG- tongue)
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