title: [The management of the difficult pediatric airway].
abstract: BACKGROUND
  We are faced sometimes with the difficult pediatric airway due to congenital abnormalities. However, there has been no systematic examination for the management of the difficult pediatric airway.
  
  
  METHODS
  We retrospectively examined the incidence of difficult airway in 13,557 pediatric patients who had undergone general anesthesia with tracheal intubation. The difficulties of the intubation were classified into grade 1 to 4; grade 1: intubated one time, grade 2: two times, grade 3: three times or more, grade 4: changed to another way. We defined grade 3 and 4 as "difficult airway".
  
  
  RESULTS
  Twenty-five patients (0.17%) are "difficult airway" among 13,557 patients in which 21 patients (0.15%) are classified as grade 3, and 4 patients (0.02%) are grade 4. The difficulties were significantly different among the syndromes (P< 0.001). The rate of the incidence in the difficulty is high in Treacher Collins syndrome, arthrogryposis multiprex congenita and first and second brachial arch syndrome, but few is in Pierre-Robin syndrome, Crouzon syndrome and Apert syndrome which are known to accompany difficult airway.
  
  
  CONCLUSIONS
  We demonstrated that the incidence of difficult airway is different among the syndromes.
authors.affiliation: Department of Anesthesiology and Reanimatology, Faculty of Medicine, University of Fukui, Fukui 910-1104.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Isada
authors.forename: Takaaki
authors.initials: T
authors.lastname: Miwa
authors.forename: Koichi
authors.initials: K
authors.lastname: Hiroki
authors.forename: Satoru
authors.initials: S
authors.lastname: Fukuda
mesh_terms: D000768:Anesthesia, General / Q000379:methods; D002675:Child, Preschool; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D012189:Retrospective Studies; D014132:Trachea / Q000002:abnormalities