Upper airway obstruction in children.

Poiseuille’s law is central to the understanding and management of all airway obstructions in children, with the clinical impact of even a small reduction in radius being compounded by the inverse relationship of the resistance to the radius to the power 4. Indeed deterioration from a ‘mild’ obstruction to life threatening airway compromise may be heralded by slight decrease in airway diameter (Figure 1). Successful outcome in all cases of childhood airway obstruction is dependant upon the efficient cooperation between suitably experienced otolaryngologists, anesthetists, and intensivists. The aim of this article is to discuss the presentation, assessment, and management of the common causes of childhood airway obstruction as seen in a tertiary level unit. Traditionally, airway management often comprised tracheostomy insertion, but the development of endoscopic techniques has superseded this in an ever increasing proportion of cases. Treatment strategies and principles will be highlighted and placed in context with results reported in the literature.