Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Ansan, Korea.
Korean J Anesthesiol. 2011 Feb;60(2):119-23. doi: 10.4097/kjae.2011.60.2.119. Epub 2011 Feb 25.
We present here the case of a 33-month-old male patient with Wolf-Hirschhorn syndrome (WHS) and who underwent tympanoplasty and myringotomy. WHS is caused by a rare chromosomal abnormality, which is the deletion of the short arm of chromosome number 4. The typical craniofacial features of WHS patients such as micrognathia, microcephaly and the muscular weakness can make using neuromuscular blocking agents and performing intubation difficult. Moreover, there are a few previous case reports showing that malignant hyperthermia occurred during and after an operation in which the anesthesia was done with inhalation agents, so special anesthetic care is needed when operating on a WHS patient. By carefully intubating the patient and using total intravenous anesthesia, we performed successful anesthesia without any complications. We describe here the anesthetic management of a WHS patient and we review the relevant literature.
我们在此介绍了一例 33 个月大的男性 Wolf-Hirschhorn 综合征(WHS)患者,他接受了鼓室成形术和鼓膜切开术。WHS 是由一种罕见的染色体异常引起的,即 4 号染色体短臂缺失。WHS 患者的典型颅面特征,如小颌畸形、小头畸形和肌肉无力,会使使用神经肌肉阻滞剂和进行插管变得困难。此外,有少数先前的病例报告表明,在吸入剂麻醉下进行手术期间和之后发生了恶性高热,因此在对 WHS 患者进行手术时需要特殊的麻醉护理。通过仔细插管和使用全静脉麻醉,我们成功地进行了麻醉,没有任何并发症。我们在此描述了一例 WHS 患者的麻醉管理,并回顾了相关文献。