Padmanabhan Karthikeyan, Ashish Sharad, Vijayan Neelima, Hemanthkumar Swaati Mukilan
Otolaryngology - Head and Neck Surgery, Mahatma Gandhi Medical College and Research Institute, Pondicherry, IND.
Otolaryngology - Head and Neck Surgery, Srinivasan Medical College and Hospital, Tiruchirappalli, IND.
Cureus. 2024 Aug 5;16(8):e66233. doi: 10.7759/cureus.66233. eCollection 2024 Aug.
Bardet-Biedl syndrome (BBS) is a rare autosomal recessive ciliopathy characterized by diverse multisystem manifestations. This report discusses the unique otorhinolaryngological challenges faced by two pediatric siblings diagnosed with BBS. Case 1 involves a child with a history of chronic snoring, delayed developmental milestones, and a low intelligence quotient (IQ). The patient presented with obesity, retinitis pigmentosa, and a rare bifid epiglottis, adding to the complexity. Adenotonsillectomy was indicated due to chronic adenotonsillitis, but the presence of a grade 4 Mallampati score and restricted mouth opening required meticulous planning by the surgical and anesthesia teams. The collaborative approach led to a successful procedure, emphasizing the importance of interdisciplinary coordination in managing complex cases. Case 2, the younger sibling, presented with disturbed sleep cycles, mouth breathing, and difficulty swallowing. Adenotonsillectomy was performed for chronic adenotonsillitis, providing relief initially. However, recurrent adenoid hypertrophy, covering 90% of choanae, manifested two years later. The case highlights the need for long-term follow-up and raises questions about the underlying mechanisms contributing to recurrent adenoid hypertrophy in BBS. These cases underscore the rarity and intricacy of otorhinolaryngological manifestations in BBS, emphasizing the importance of comprehensive and multidisciplinary management. The challenges posed by anatomical abnormalities and recurrent adenoid hypertrophy necessitate ongoing research for effective long-term strategies in treating these complex genetic conditions. These findings contribute to the limited literature on BBS within the otorhinolaryngology domain and underscore the significance of continued collaboration and research efforts in optimizing patient care.
巴德-比德尔综合征(BBS)是一种罕见的常染色体隐性遗传性纤毛病,具有多种多系统表现。本报告讨论了两名被诊断为BBS的儿科兄弟姐妹所面临的独特耳鼻咽喉科挑战。病例1涉及一名有慢性打鼾、发育里程碑延迟和低智商(IQ)病史的儿童。该患者还伴有肥胖、色素性视网膜炎和罕见的双叶会厌,这增加了病情的复杂性。由于慢性腺样体扁桃体炎,建议进行腺样体扁桃体切除术,但4级马兰帕蒂评分和张口受限的情况要求手术和麻醉团队进行精心规划。这种协作方法导致手术成功,强调了跨学科协调在处理复杂病例中的重要性。病例2是较年幼的兄弟姐妹,表现为睡眠周期紊乱、口呼吸和吞咽困难。因慢性腺样体扁桃体炎进行了腺样体扁桃体切除术,最初病情有所缓解。然而,两年后出现了复发性腺样体肥大,覆盖了90%的后鼻孔。该病例突出了长期随访的必要性,并引发了关于BBS中导致复发性腺样体肥大的潜在机制的问题。这些病例强调了BBS中耳鼻咽喉科表现的罕见性和复杂性,强调了综合和多学科管理的重要性。解剖异常和复发性腺样体肥大带来的挑战需要持续研究有效的长期治疗策略来应对这些复杂的遗传疾病。这些发现为耳鼻咽喉科领域内关于BBS的有限文献做出了贡献,并强调了持续合作和研究努力在优化患者护理方面的重要性。