Bhargava Deepa, Sharma Jasvinder, Al-Abri Rashid
ENT Division, Department of Surgery, College of Medicine, Sultan Qaboos University Hospital, Oman.
Int J Pediatr Otorhinolaryngol. 2012 Jan;76(1):149-51. doi: 10.1016/j.ijporl.2011.10.010. Epub 2011 Nov 1.
We report a rare, silent, potentially fatal operative complication of seven hour apnoea in a patient undergoing adenotonsillectomy secondary to deficiency of plasma cholinesterase. Awareness of this hereditary disorder is important to otolaryngologist as; it is difficult to diagnose, can be unexpectedly alarming for parents and the surgeon.
Case report and review of world literature.
A four-year male with obstructive sleep apnoea underwent a routine elective adenotonsillectomy; there was no spontaneous recovery of respiration following surgery. He was transferred to the intensive care unit and 7 h later was successfully weaned from the ventilator and extubated. A plasma cholinesterase level of 456 1U/L was discovered much later.
To our knowledge this is the first case report of pseudo cholinesterase deficiency reported in otolaryngology literature and first in Oman. The patient should receive information about the condition, the associated risks, inheritance and need for testing other family members.
我们报告了一例罕见的、无症状的、潜在致命的手术并发症，一名因血浆胆碱酯酶缺乏而接受腺样体扁桃体切除术的患者出现了长达7小时的呼吸暂停。耳鼻喉科医生了解这种遗传性疾病很重要，因为它难以诊断，可能会让家长和外科医生意外警觉。
病例报告及世界文献回顾。
一名患有阻塞性睡眠呼吸暂停的4岁男性接受了常规择期腺样体扁桃体切除术；术后呼吸未自主恢复。他被转入重症监护病房，7小时后成功脱机并拔管。很久之后才发现血浆胆碱酯酶水平为456 IU/L。
据我们所知，这是耳鼻喉科文献中报道的首例假性胆碱酯酶缺乏病例，也是阿曼的首例。应向患者提供有关该疾病、相关风险、遗传情况以及检测其他家庭成员必要性的信息。
