Kaji Junko, Higashi Midoriko, Sakaguchi Yoshiro, Maki Jun, Kai Tetsuya, Yamaura Ken, Hoka Sumio
Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, Fukuoka 812-8582.
Masui. 2010 Dec;59(12):1526-8.
Goldenhar syndrome is associated with difficult airway due to the characteristic craniofacial anomalies such as hypoplasia of the mandible and molar bones. We present our method of fiberoptic intubation using two tracheal tubes for a girl with Goldenhar syndrome undergoing cochlear implant surgery. She had received general anesthesia for dental treatment one year before, but the treatment had been cancelled because of the failure of tracheal intubation. We induced anesthesia for her with inhalation of sevoflurane and nitrous oxide. After obtaining a stable anesthetic level, we inserted two tracheal tubes from the right and left nostrils, one for a tracheal tube and the other for a nasopharyngeal airway. During the procedure, the fiberscope was advanced through the tracheal tube with a slit connector, and her ventilation was assisted through the nasopharyngeal airway with her mouth closed by a tape to avoid a leak of ventilating gas. Using this two-tube method, we successfully intubated the trachea of a patient Goldenhar syndrome.
Goldenhar综合征因下颌骨和磨牙骨发育不全等典型颅面畸形而与困难气道相关。我们介绍了为一名患有Goldenhar综合征的女童在进行人工耳蜗植入手术时使用两根气管导管进行纤维支气管镜引导插管的方法。她在一年前因牙科治疗接受过全身麻醉，但因气管插管失败而取消了治疗。我们通过吸入七氟醚和氧化亚氮为她诱导麻醉。在达到稳定的麻醉平面后，我们从左右鼻孔插入两根气管导管，一根作为气管导管，另一根作为鼻咽通气道。在操作过程中，纤维支气管镜通过带有狭缝连接器的气管导管推进，通过用胶带封闭其口腔经鼻咽通气道辅助通气，以避免通气气体泄漏。使用这种双管法，我们成功地为一名Goldenhar综合征患者进行了气管插管。
