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Down Syndrome Airway Features — FRCA Final MCQ

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ModeratePaediatric AnaesthesiaDown Syndrome Airway FeaturesFRCA Final

A 1-year-old (10 kg) with Trisomy 21 is listed for cardiac surgery. Most relevant airway feature?

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Correct answer: A — Macroglossia and subglottic stenosis

Macroglossia and subglottic stenosis are most directly relevant for airway management in Down syndrome. Subglottic stenosis → ETT may need 1-2 sizes smaller. Macroglossia/midface hypoplasia cause difficult mask ventilation. Atlantoaxial instability (~10-15%) important for positioning but primarily spinal cord concern.

Reference: APAGBI – 2023 – Anaesthesia for children with Down syndrome