Abstract: The difficult airway may present to us in many forms in a child put up for planned surgery.I will discuss a few cases which left us breathless.
A 15 day old neonate with Cystic hygroma of the neck extending to the midline at the back.Flexion and extension was not possible bcause of the mass.
A 2 month old baby with Pierre-Robin syndrome put up for bilateral inguinal hernia.The baby had a history of failed intubation 7 days back.
A 1 year old male baby with huge hydrocephalus causing great difficulty in laryngoscopy and intubation which had to be overcome with correct positioning.
Giant occipital encephalocele is a nightmare to any anaesthesiologist.In these patients the baby and the swelling have to be supported by more than one person.Intubation in the lateral position can be tried or the position has to be made suitable.A 21 day old baby was posted for removal of this and shunt.
Giant lumbo-sacral meningomyelocele does not allow the patient to lie supine and so have to be placed laterally or put on two pillows with the swelling in between and supported with cotton.A 1 month old male baby was taken for operation.

METHODS : we did a retrospective study on the patients and the different methods used to tackle the airway are evaluated

RESULTS : the patients were intubated and the surgery carried out as planned

CONCLUSIONS : a difficult airway can be managed using proper homework