Airway management can be challenging in patients with down syndrome because their:

Because their TEETH ARE MISALIGNED AND THEY USUALLY POSSESS LONG TONGUE. Respiratory illness is common in people who have down syndrome and their unique airway anatomical factors makes airway management difficult during respiratory distress. For instance, they have narrower upper airway and smaller trachea.

The answer would be cstep by step explanation: all of the other animals developed their features while the salamander was born with them