Which condition would heighten the risk of difficult airway management in a child?

• A. Cystic fibrosis
• B. Treacher Collins syndrome
• C. Juvenile idiopathic arthritis
• D. Sickle cell disease

Answer: (B)

Anatomical airway abnormalities in the face and jaw make securing the airway in children much more challenging. Treacher Collins syndrome features underdeveloped facial bones, including mandibular hypoplasia and micrognathia, often with maxillary hypoplasia and airway crowding. These changes shrink the oral opening and misalign the airway axis, so mask ventilation can be difficult and laryngoscopic visualization of the glottis is frequently poor. Because of that distorted anatomy, planning for a difficult airway—having alternative intubation techniques ready and possibly considering awake or alternative route approaches—is essential.

Cystic fibrosis mainly affects the lungs and mucous clearance, not the airway structure itself, so it doesn’t inherently create a difficult airway. Juvenile idiopathic arthritis can limit neck movement or jaw opening due to joint involvement, which can complicate airway management, but it’s less consistently associated with the pronounced facial structural abnormalities that Treacher Collins presents. Sickle cell disease raises anesthesia-related risks (like crisis or hypoxia) but does not by itself define a difficult airway anatomy.