Handler S D, Keon T P
Ann Otol Rhinol Laryngol. 1983 Jul-Aug;92(4 Pt 1):401-4. doi: 10.1177/000348948309200423.
The child with mandibular hypoplasia (Treacher Collins syndrome, Pierre Robin sequence, hemifacial microsomia, etc) presents the otolaryngologist and anesthesiologist with considerable problems when direct laryngoscopy and/or endotracheal intubation is attempted. In addition to the small mandible, several other features of these patients contribute to the difficult laryngoscopy: macroglossia, glossoptosis, trismus related to temporomandibular joint abnormalities, and prominent maxilla or maxillary incisors. Most of the techniques that have been described for laryngoscopy/intubation in problem cases are difficult or impossible to use in infants and young children with mandibular hypoplasia. We present a modification of the standard direct laryngoscopic procedure, utilizing the 9-cm anterior commissure laryngoscope and an optical stylet in the task of exposing and intubating the larynx of a child with mandibular hypoplasia.
患有下颌骨发育不全（如特雷彻·柯林斯综合征、皮埃尔·罗宾序列征、半侧颜面短小畸形等）的儿童在尝试直接喉镜检查和/或气管插管时，给耳鼻喉科医生和麻醉医生带来了相当大的问题。除了下颌骨小之外，这些患者的其他几个特征也导致喉镜检查困难：巨舌症、舌后坠、与颞下颌关节异常相关的牙关紧闭，以及突出的上颌骨或上颌切牙。已描述的大多数用于疑难病例喉镜检查/插管的技术，在患有下颌骨发育不全的婴幼儿中很难或无法使用。我们介绍一种标准直接喉镜检查程序的改良方法，在为患有下颌骨发育不全的儿童暴露和插管喉部的操作中，使用9厘米的前联合喉镜和光导探条。
