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下颌骨成釉细胞瘤的麻醉挑战:一例报告

Anesthetic Challenges in Ameloblastoma of the Mandible: A Case Report.

作者信息

Khatavkar Sonal, Raveendran Nayana

机构信息

Anaesthesiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND.

出版信息

Cureus. 2024 Aug 12;16(8):e66741. doi: 10.7759/cureus.66741. eCollection 2024 Aug.

DOI:10.7759/cureus.66741
PMID:39268316
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11391164/
Abstract

Ameloblastoma is a rare, locally aggressive benign tumor primarily affecting the mandible, with an incidence of 0.92 cases per million person-years and a male predominance. A two-year-old male presented with a right mandibular mass. CT imaging and histopathology confirmed ameloblastoma. He underwent wide local excision, mandibulectomy, and pectoralis major myocutaneous flap reconstruction under general anesthesia. Preoperative assessment revealed potential airway challenges; intubation was achieved with the backward, upward, rightward pressure (BURP) maneuver, and tracheostomy was performed to secure postoperative airway patency. The surgery was uneventful, and the patient was successfully weaned off ventilatory support by postoperative day four. This case underscores the importance of careful planning and expertise in pediatric ameloblastoma management, highlighting the effectiveness of direct laryngoscopy with BURP maneuver and prophylactic tracheostomy.

摘要

成釉细胞瘤是一种罕见的、具有局部侵袭性的良性肿瘤,主要累及下颌骨,发病率为每百万人口年0.92例,男性居多。一名两岁男性患儿出现右下颌肿物。CT成像和组织病理学检查确诊为成釉细胞瘤。他在全身麻醉下接受了广泛局部切除、下颌骨切除术及胸大肌肌皮瓣重建术。术前评估发现存在潜在气道问题;通过向后、向上、向右施压(BURP)手法成功插管,并进行气管切开以确保术后气道通畅。手术过程顺利,术后第4天患者成功脱机。该病例强调了在儿童成釉细胞瘤治疗中精心规划和专业技能的重要性,突出了直接喉镜检查联合BURP手法及预防性气管切开的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4936/11391164/e63c5616f825/cureus-0016-00000066741-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4936/11391164/e63c5616f825/cureus-0016-00000066741-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4936/11391164/e63c5616f825/cureus-0016-00000066741-i01.jpg

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