Stevenson G W, Hall S C, Bauer B S, Vicari F A, Seleny F L
Children's Memorial Hospital, Department of Anesthesiology, Chicago, Illinois 60614.
Can J Anaesth. 1991 Nov;38(8):1046-9. doi: 10.1007/BF03008625.
Miller's syndrome is a rare congenital disorder with facial features similar to that of Treacher-Collins syndrome. This report details the anaesthetic management of an infant during multiple surgical procedures, beginning with pylormyotomy at one month of age. Airway management was difficult because of severe micrognathia and was accomplished using an awake intubation with a conventional straight blade modified for continuous administration of oxygen ("oxyscope"). Due to recurrent upper airway obstruction and the anticipated need for multiple surgical procedures in the first years of life, a tracheostomy was placed. Because of the multiple airway, orthopaedic, and nutritional difficulties, it is important that a prospective, multidisciplinary approach be used in these patients' care. Consideration should be given to early tracheostomy for airway maintenance.
米勒综合征是一种罕见的先天性疾病，其面部特征与特雷彻-柯林斯综合征相似。本报告详细介绍了一名婴儿在多次外科手术期间的麻醉管理情况，该婴儿在1个月大时开始进行幽门肌切开术。由于严重小颌畸形，气道管理困难，通过使用经改良可连续输氧的传统直喉镜进行清醒插管（“氧气喉镜”）完成。由于反复出现上呼吸道梗阻，且预计在生命的头几年需要进行多次外科手术，因此进行了气管造口术。鉴于存在多种气道、骨科和营养方面的困难，对这些患者的护理采用前瞻性、多学科方法很重要。应考虑早期进行气管造口术以维持气道。
