Khan Waqas Ahmed, Salim Bushra, Khan Ausaf Ahmed, Chughtai Shakaib
Department of Anaesthesia, The Aga Khan University Hospital, Karachi.
J Coll Physicians Surg Pak. 2017 Mar;27(3):S6-S7.
Goldenhar syndrome is a congenital disorder involving deformities of the face. It usually affects one side of the face only and poses significant challenges in the airway management. We herein, report an 8-year boy, known case of Goldenhar syndrome, who presented to our radiology suite for a magnetic resonance imaging (MRI) brain, followed by a computed tomography (CT) scan brain. The boy had various features of Goldenhar syndrome, e.g. cleft palate, absent right eye and ear, right mandibular hypoplasia, micrognathia, and preauricular tags. His developmental milestones were delayed. Airway evaluation showed Mallampati class II with limited movements of head and neck, which suggested possibility of difficult laryngoscopy and intubation. He had no vertebral anomalies or cardiac disease. A difficult airway continues to be a major cause of anaesthesia-related morbidity and mortality; and maintaining spontaneous breathing remains a vital technique in its management. Lack of anaesthesia-related complications with supraglottic devices encouraged us to present the advantage of utilising a laryngeal mask airway (LMA) under anaesthesia for successful management of predicted difficult airway.
Goldenhar综合征是一种涉及面部畸形的先天性疾病。它通常仅影响面部的一侧,给气道管理带来重大挑战。我们在此报告一名8岁男孩,他是已知的Goldenhar综合征病例,前来我们的放射科进行脑部磁共振成像(MRI)检查,随后进行脑部计算机断层扫描(CT)。该男孩具有Goldenhar综合征的各种特征,例如腭裂、右眼和右耳缺失、右下颌发育不全、小颌畸形和耳前赘生物。他的发育里程碑延迟。气道评估显示Mallampati II级,头颈部活动受限,这提示喉镜检查和插管困难的可能性。他没有脊柱异常或心脏病。困难气道仍然是麻醉相关发病率和死亡率的主要原因;维持自主呼吸仍然是其管理中的一项重要技术。声门上装置未出现麻醉相关并发症,这促使我们介绍在麻醉下使用喉罩气道(LMA)成功管理预计困难气道的优势。