may result in airway difficulty  

Syndromes Associated with Difficult Airway Management *

                                                                                       William H. Rosenblatt

CONGENITAL

Pierre Robin syndrome

Micrognathia, macroglossia, glossoptosis, cleft soft palate

Treacher Collins syndrome (mandibulofacial dysostosis)

Auricular and ocular defects; malar and mandibular hypoplasia, microstomia, choanal atresia

Goldenhar's syndrome (oculo–auriculo–vertebral syndrome)

Auricular and ocular defects; malar and mandibular hypoplasia; occipitalization of atlas

Down's syndrome (mongolism)

Poorly developed or absent bridge of the nose; macroglossia, microcephaly, cervical spine abnormalities

Klippel-Feil syndrome

Congenital fusion of a variable number of cervical vertebrae; restriction of neck movement

Alpert's syndrome (acrocephalosyndactyly)

Maxillary hypoplasia, prognathism, cleft soft palate, tracheobronchial cartilaginous anomalies

Beckwith's syndrome (infantile gigantism)

Macroglossia

Cherubism

Tumorous lesion of mandibles and maxillae with intraoral masses

Cretinism (congenital hypothyroidism)

Absent thyroid tissue or defective synthesis of thyroxine; macroglossia, goiter, compression of trachea, deviation of larynx/trachea

Cri du chat syndrome

Chromosome 5-P abnormal; microcephaly, micrognathia, laryngomalacia, stridor

Meckel's syndrome

Microcephaly, micrognathia, cleft epiglottis

von Recklinghausen disease (neurofibromatosis)

Increased incidence of pheochromocytoma; tumors may occur in the larynx and right ventricle outflow tract

Hurler's syndrome (mucopolysaccharidosis I)

Stiff joints, upper airway obstruction because of infiltration of lymphoid tissue; abnormal tracheobronchial cartilages

Hunter's syndrome (mucopolysaccharidosis II)

Same as in Hurler's syndrome, but less severe; pneumonias

Pompe's disease (glycogen storage II)

Muscle deposits, macroglossia

ACQUIRED

Infections

Supraglottitis

Laryngeal edema

Croup

Laryngeal edema

Abscess (intraoral, retropharyngeal)

Distortion and stenosis of the airway and trismus

Papillomatosis

Chronic viral infection forming obstructive papillomas, primarily supraglottic

Ludwig's angina

Distortion and stenosis of the airway and trismus

Arthritis

Rheumatoid arthritis

Temporomandibular joint ankylosis, cricoarytenoid arthritis, deviation of larynx, restricted mobility of cervical spine

Ankylosing spondylitis

Ankylosis of cervical spine; less commonly ankylosis of temporomandibular joints; lack of mobility of cervical spine

Benign Tumors

Cystic hygroma, lipoma, adenoma, goiter

Stenosis or distortion of the airway

Malignant Tumors

Carcinoma of tongue, carcinoma of larynx, carcinoma of thyroid

Stenosis or distortion of the airway; fixation of larynx or adjacent tissues (e.g., infiltration or fibrosis from irradiation)

Trauma

Head injury, facial injury, cervical spine injury

Cerebrospinal rhinorrhea, edema of the airway; hemorrhage; unstable fracture(s) of the maxillae and mandible; intralaryngeal damage

Miscellaneous Conditions

Morbid obesity

Short, thick neck and large tongue are likely to be present

Acromegaly

Macroglossia; prognathism

Acute burns

Edema of airway

Physiologic conditions

pregnancy