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This is a summary of pediatric syndromes and associated airway abnormalities that might make ventilation or intubation difficult. **Down syndrome also associated with atlantoaxial instability REFERENCES: Adapted from Wikipedia, UpToDate, TrueLearn, StatPearls. By Sydney S. Gellis and Murray Feingold - Atlas of mental retardation syndromes; visual diagnosis of facies and physical findings, Public Domain, https://commons.wikimedia.org/w/index.... By De Golovine, S., Wu, S., Hunter, J.V. et al. - De Golovine, S., Wu, S., Hunter, J.V. et al. Goldenhar syndrome: a cause of secondary immunodeficiency?. All Asth Clin Immun 8, 10 (2012) doi:10.1186/1710-1492-8-10, CC BY 2.0, https://commons.wikimedia.org/w/index.... By Leena Goel, Santosh Kumar Bennur, Shweta Jambhale - Goel L, Bennur SK, Jambhale S. (2009 Aug). "Treacher-Collins Syndrome–A Challenge For Anaesthesiologists". Indian J Anaesth. 53 (4): 496-500. PMID 20640217. PMC: 2894488.Open-i, CC BY 2.0, https://commons.wikimedia.org/w/index.... By Vanellus Foto - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index... By Sydney S. Gellis and Murray Feingold - Atlas of mental retardation syndromes; visual diagnosis of facies and physical findings, Public Domain, https://commons.wikimedia.org/w/index... By Sydney S. Gellis and Murray Feingold - Atlas of mental retardation syndromes; visual diagnosis of facies and physical findings, Public Domain, https://commons.wikimedia.org/w/index... By KateVUk - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index... By Sydney S. Gellis and Murray Feingold - Atlas of mental retardation syndromes; visual diagnosis of facies and physical findings, Public Domain, https://commons.wikimedia.org/w/index... ADDITIONAL TAGS: Pierre Robin Trisomy 21 Treacher Collins Goldenhar Hurler Hunter Crouzon Morquio Cleft palate, micrognathia, glossoptosis (posteriorly displaced tongue) Heart disease. Awake intubation; tracheostomy Macroglossia (large tongue), small mouth opening, and subglottic stenosis. Laryngospasm common Micrognathia, aplastic zygomatic arches, microstomia, choanal atresia. Congenital heart disease Mandibular hypoplasia, unilateral facial hypoplasia (eye, ear, vertebral abnormalities); preauricular skin tags Coarse facial features, kyphoscoliosis, abnormal tracheobronchial cartilage; Macroglossia, small mouth opening, and excessive thick secretions. Worse with age Coarse facial features, macrocephaly; Macroglossia, small mouth opening, and excessive thick secretions. Worse with age Wide skull with proptosis, beaked nose, maxillary hypoplasia → difficulty masking, beaked nose Coarse facial features, prognathism, odontoid hypoplasia, atlantoaxial instability; Macroglossia, small mouth opening, and excessive thick secretions