The anatomy of the infant’s airway is different in some respects from that of the adult

The anatomy of the infant’s airway is different in some respects from that of the adult. The infant head is relatively larger than the adult’s head. The larynx is in a more cephalad position in the infant than in the adult (infant’s C3-C4, adult’s C4-C5). The infant’s epiglottis is narrower and “omega” shaped, whereas the adult epiglottis is flat and broad. Because the angle between the base of the tongue and the vocal cords is more acute in infants compared with adults, straight laryngoscope blades are used like curved blades for laryngoscopy in infants. The axis of the vocal cords in the adult is perpendicular to the axis of the larynx and trachea, whereas in the infant the anterior insertion of the vocal cords is lower (caudad) compared with the posterior insertion of the vocal cords. This diagonal position of the vocal cords relative to the axis of the larynx and trachea makes it more likely tohave the ETT lodge in the anterior commissure of the vocal cords rather than slide down the trachea when the infant is intubated. The narrowest part of the adult larynx and the infant airway is the same, at the level of the cricoid ring