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Pediatric Airway & Anesthesia

Airway Obstruction Calculator

Estimate percent subglottic obstruction and Cotton-Myer grade from patient age and the largest endotracheal tube that passes the stenosis.

Calculate obstruction

Airway obstruction assessment
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Clinical correlation required. This estimates grade from ETT sizing; direct endoscopy is essential for diagnosis.

Cotton-Myer grades

Grade I
0–50%
Mild stenosis — usually well tolerated.
Grade II
51–70%
Moderate stenosis — may cause respiratory symptoms.
Grade III
71–99%
Severe stenosis — significant airway compromise.
Grade IV
No lumen
Complete obstruction — critical airway emergency.

Percent obstruction reference

Age 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5
Pre-term (younger)40%
Pre-term (older)58%30%
0–3 months68%48%26%
3–9 months75%59%41%22%
9 months – 2 years80%67%53%38%20%
2 years84%74%62%50%35%19%
4 years86%78%68%57%45%32%17%
6 years89%81%73%64%54%43%30%16%
References. Myer CM 3rd, O’Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol. 1994;103(4):319–23. · Propst EJ, et al. Myer-Cotton grade of subglottic stenosis depends on style of endotracheal tube used. Laryngoscope. 2023;133(10):2721–2725.
Disclaimer. For educational and reference use by qualified clinicians only. Percentages are Myer-Cotton estimates; direct endoscopic visualization is essential for diagnosis and grading. Does not replace clinical judgment.