Why can airway management be challenging in patients with Down syndrome?

Airway management can be particularly challenging in patients with Down syndrome due to anatomical variations that affect their ability to maintain a clear airway. One of the most significant factors is the presence of misaligned teeth and a larger-than-usual tongue. This combination can lead to difficulties during intubation and may also increase the risk of airway obstruction, particularly in situations where rapid intervention is required.

The larger tongue, also known as macroglossia, can obstruct the airway, especially in a supine position. Additionally, misaligned teeth can complicate the insertion of airway devices, making it harder for emergency responders to secure the airway effectively. Therefore, recognizing these specific anatomical features is crucial for healthcare providers when managing the airway in patients with Down syndrome.