Comparison of propofol and ketamine induced anatomical upper airway changes in children at magnetic resonance imaging

The exact anatomical site of anesthesia-induced airway obstruction is controversial [3,6-11]. The traditional knowledge postulates that the posterior movement of the tongue by a reduced genioglossus activity is the major cause of airway obstruction [12-14]. More recent studies suggest that the airway obstruction occurs at different sites, such as at the level of epiglottis or soft palate [69,11]. Children are more susceptible to airway obstruction because of smaller dimensions of their airways and the high incidence of tonsillar or adenoidal hypertrophy causing increased resistance [13]. However, the configurational changes leading to obstruction in the upper airway during anesthesia in children are not definite [12].