Widespread interest and research into the paediatric upper airway has
relatively recent origins. Indeed, in a state-of-the-art paper on the
development of-the respiratory system published only 15 years ago virt
ually no attention was paid to this subject (Polgar and Weng, 1979). W
e will initially explore the embryological origin of the structures th
at form the airway, scrutinize the particularly significant anatomical
features of each section in turn, develop a physiological perspective
by focusing on some principles that govern airflow through this compo
site tube, and finally discuss the often unique pathophysiological der
angements that befall the infant and child in this vulnerable area. It
is important to appreciate that the nose, pharynx, larynx and trachea
comprise a bottleneck in the paediatric airway, with obstruction ther
e being potentially fatal.