Anatomical differences between adult and pediatric airways are well documented in the literature.1 Compared with adults, infants have a proportionately larger tongue situated entirely within the oropharynx; they are obligate nose breathers, and they have narrower nostrils in relation to the trachea, a higher and smaller larynx, and an elongated more rigid omega-shaped epiglottis. For all of these anatomical reasons, infants are susceptible to airway obstruction, respiratory failure, and difficult endotracheal intubation. The descent of the larynx in the first year of life is a characteristic exclusive to hominids - the larynx and epiglottis descend away from the soft palate creating a common passage for air, food, and liquid, and the base of the tongue becomes the anterior wall of the oropharynx.
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