Esa Umairah, Singh Navkiran G, Mohamad Hazama, Zaini Rhendra H M
Department of Anaesthesiology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia.
Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia.
Saudi J Anaesth. 2024 Jul-Sep;18(3):432-434. doi: 10.4103/sja.sja_978_23. Epub 2024 Jun 4.
Acquired subglottic stenosis is a common complication of endotracheal intubation in infants. The risk increases in trisomy 21, patients undergoing bypass surgery, and having gastroesophageal reflux disease. Less invasive endoscopic balloon dilatation of subglottic stenosis has become a more common treatment modality compared to open surgical technique. Airway-related surgery needs meticulous preparation and good communication between the anesthetist, surgeon, and staff. More precaution and more effective preparation and communication are needed in neonatal airway surgery as it is physiologically easier to desaturate and develop hypoxemia compared to adults. We report a case of successful balloon dilation of Myer-Cotton class III subglottic stenosis with intermittent supraglottic jet ventilation and bag-mask ventilation in infants with trisomy 21.
获得性声门下狭窄是婴儿气管插管常见的并发症。21三体综合征、接受搭桥手术以及患有胃食管反流病的患者发生该并发症的风险会增加。与开放性手术技术相比，侵入性较小的内镜下球囊扩张术已成为治疗声门下狭窄更常用的方式。气道相关手术需要麻醉医生、外科医生及医护人员之间进行细致的准备和良好的沟通。新生儿气道手术需要更多的预防措施以及更有效的准备和沟通，因为与成人相比，新生儿在生理上更容易出现血氧饱和度下降和低氧血症。我们报告一例成功通过球囊扩张术治疗21三体综合征婴儿迈耶-科顿III级声门下狭窄的病例，术中采用间歇性声门上喷射通气和面罩通气。
