A case of safe airway management by fiber-optic nasotracheal intubation in general anesthesia in a pediatric patient with Hajdu-Cheney syndrome: a case report.
Airway management
Difficult airway
Hajdu-Cheney syndrome
Nasotracheal intubation
Journal
JA clinical reports
ISSN: 2363-9024
Titre abrégé: JA Clin Rep
Pays: Germany
ID NLM: 101682121
Informations de publication
Date de publication:
12 Jun 2023
12 Jun 2023
Historique:
received:
06
04
2023
accepted:
02
06
2023
revised:
22
05
2023
medline:
12
6
2023
pubmed:
12
6
2023
entrez:
12
6
2023
Statut:
epublish
Résumé
Hajdu-Cheney syndrome (HCS) is an extremely rare disorder characterized by progressive acro-osteolysis. A unique facial structure and deformity of the cervical spine are associated with a difficult airway. Although several reports describe general anesthesia with orotracheal intubation for patients with HCS, there have been no reports of nasotracheal intubation with a risk of skull base fracture. We describe nasotracheal intubation for oral surgery in a patient with HCS. A 13-year-old girl with HCS was scheduled for dental surgery. Preoperative computed tomography revealed no abnormalities including fractures in the skull base or cervical spine. After confirming a lack of vocal cord paralysis by bronchofiberscopic inspection from the nose, general anesthesia was induced with sevoflurane, remifentanil, and rocuronium. Fiber-optic nasotracheal intubation was successfully performed without complications such as depletion of oxygen saturation and massive epistaxis, and the surgery was completed uneventfully. She was discharged the day after surgery with no anesthesia-related complications. We were able to safely manage the airway of a patient with HCS by nasotracheal intubation under general anesthesia.
Sections du résumé
BACKGROUND
BACKGROUND
Hajdu-Cheney syndrome (HCS) is an extremely rare disorder characterized by progressive acro-osteolysis. A unique facial structure and deformity of the cervical spine are associated with a difficult airway. Although several reports describe general anesthesia with orotracheal intubation for patients with HCS, there have been no reports of nasotracheal intubation with a risk of skull base fracture. We describe nasotracheal intubation for oral surgery in a patient with HCS.
CASE PRESENTATION
METHODS
A 13-year-old girl with HCS was scheduled for dental surgery. Preoperative computed tomography revealed no abnormalities including fractures in the skull base or cervical spine. After confirming a lack of vocal cord paralysis by bronchofiberscopic inspection from the nose, general anesthesia was induced with sevoflurane, remifentanil, and rocuronium. Fiber-optic nasotracheal intubation was successfully performed without complications such as depletion of oxygen saturation and massive epistaxis, and the surgery was completed uneventfully. She was discharged the day after surgery with no anesthesia-related complications.
CONCLUSIONS
CONCLUSIONS
We were able to safely manage the airway of a patient with HCS by nasotracheal intubation under general anesthesia.
Identifiants
pubmed: 37306808
doi: 10.1186/s40981-023-00627-7
pii: 10.1186/s40981-023-00627-7
pmc: PMC10260714
doi:
Types de publication
Journal Article
Langues
eng
Pagination
33Informations de copyright
© 2023. The Author(s).
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