Jain Gaurav, Barik Amiya Kumar, Banerjee Amrita, S Naveen, Chug Ashi
Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, 249203, Uttarakhand, India.
Department of Dentistry and Craniomaxillofacial Surgery, All India Institute of Medical Sciences, Rishikesh, 249203, Uttarakhand, India.
J Oral Biol Craniofac Res. 2019 Jul-Sep;9(3):256-258. doi: 10.1016/j.jobcr.2019.06.008. Epub 2019 Jun 13.
Temporomandibular joint ankylosis is one of the most challenging airway disorders associated with varying anatomical abnormalities like adenotonsillar hypertrophy, craniofacial malformations, macroglossia, etc. This case highlights the intubation difficulties confronted during the airway management of a 10-year-old girl presenting lately with bilateral temporomandibular joint ankylosis, hypoplastic mandible, and adenoid hypertrophy. This patient was intubated successfully by using a suction catheter assembly to negotiate the endotracheal tube across the adenoid, and an unmatched-size flexible intubation fiberscope through a "separate insertion" technique and external laryngeal manipulation. This case emphasises the significance of a comprehensive preoperative evaluation in preparing the anaesthetic plan of an anticipated difficult airway in a paediatric population, having diverse anatomical hurdles presenting concurrently.
颞下颌关节强直是最具挑战性的气道疾病之一，与腺样体扁桃体肥大、颅面畸形、巨舌症等各种解剖异常相关。本病例突出了一名10岁女孩气道管理中面临的插管困难，该女孩近期出现双侧颞下颌关节强直、下颌骨发育不全和腺样体肥大。通过使用吸引导管组件使气管导管穿过腺样体，并采用“单独插入”技术和外部喉部操作，使用尺寸不匹配的柔性插管纤维喉镜，成功为该患者实施了插管。本病例强调了在为同时存在多种解剖障碍的儿科患者制定预期困难气道的麻醉计划时，进行全面术前评估的重要性。
