![]() ![]() Till date, no reported study has compared Miller, Macintosh and McCoy laryngoscope blades in paediatric patients of age 2–6 years. Another study suggested that in infants and children less than 2 years of age, optimal laryngoscopic view may be obtained with either Miller size 1 blade lifting the epiglottis or Miller or Macintosh blade lifting the tongue base. Previous studies have suggested that there is no significant difference in laryngoscopic view and ease of intubation between Miller and Macintosh laryngoscope blades (1–24 months age group) as well as Miller and straight McCoy laryngoscope blade (0–6 months age group). Moreover, the tonsils and adenoids appear in the second year of life and generally reach their largest size by 4–7 years, posing a risk of obstruction. At birth, larynx is situated opposite to the lower border of C4 vertebra, it descends to C4–C5 interspace by the age of 3 years and finally descends to lie opposite to the body of C5. It makes an angle of 45° with base of tongue. In paediatric population, epiglottis is large, floppy and omega-shaped. Paediatric airway is not a miniature replica of adult airway, rather it has different anatomy with different proportion and angulation.
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