Airway management in a patient with Goldenhar syndrome: a case report

Sukhupragarn, Wariya; Rosenblatt, William H.

doi:10.1016/j.jclinane.2007.09.020

Cited by 17 publications

(10 citation statements)

References 6 publications

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“…They did fiberoptic bronchoscopy assisted intubation under general anesthesia and controlled ventilation. This was anticipated as patients with Goldenhar syndrome do have difficult airway owing to restricted neck movement and calls for a thorough pre operative evaluation and intraoperative airway management an dthe need for stand by tracheostomy [8,9]. The intraoperative risks associated with Baha surgery include insufficient thickness of temporal squama, emissary vein bleeding, injury to the dura leading to csf leak and subdural hematoma.…”

Section: Discussionmentioning

confidence: 99%

Challenges During Baha Surgery: Our Experience

Marfatia¹,

Priya²,

Sathe³

et al. 2016

Indian J Otolaryngol Head Neck Surg

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Baha has proven performance and advantages for patients with aural atresia or chronic ear drainage. Being a per cutaneous osseo integrated implant the skin around the fixture is in contact with a foreign body that leads to chronic inflammatory reaction and complications such as skin irritation and overgrowth occur frequently. Challenges that are faced during Baha surgery include those during candidate selection, work up, anesthesia related as well as intra-operative and post operative complications. Ours was a retrospective and observational study where case records of 10 patients who underwent Baha surgery in the Department of E.N.T during the time period from January 2010 to June 2013 were reviewed. Here, the candidates were advised Baha either for congenital external ear deformity or single sided deafness. Out of 10 patients, who underwent Baha implantation, 8 underwent single staged Baha implant and two patients had two staged implant owing to bone thickness <3 mm behind temporo-parietal suture line on HRCT Temporal bone. The complications observed were skin infection (Holgers grade 2) around the site of implant in two patients, skin overgrowth due to more thickness of scalp (Holgers grade 4) in one of the patient. The patient had to undergo revision surgery to replace the abutment. And one of the patients underwent failure of osseointegration and was re-implanted later. Proper surgical technique and post operative wound care play an important role in avoiding complications.

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Section: Discussionmentioning

confidence: 99%

Challenges During Baha Surgery: Our Experience

Marfatia¹,

Priya²,

Sathe³

et al. 2016

Indian J Otolaryngol Head Neck Surg

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“…There is a report on successful intubation in a 4.5-year-old child with Goldenhar syndrome and associated mandibular hypoplasia by using a straight blade and a 4.0 mm tube after a failed attempt using a curved blade and a 4.5 mm tube [3]. Another case reported successful general anesthesia using a laryngeal mask airway (LMA) without intubation during ophthalmic surgery in a 10-year-old Goldenhar syndrome patient complicated with severe microsomia [4]. There is also a case of successful fiberoptic bronchoscopic intubation in a 6-year-old patient with right facial deformity and occipitocervical fusion [5].…”

Section: Discussionmentioning

confidence: 99%

“…An LMA is considered a very useful device for airway management [4,6,7]. Also, an LMA can be used as a passage for intubation, as evidenced by Johnson's use of an LMA as an method of airway management to administer anesthesia to an infant in tracheostomy.…”

Section: Discussionmentioning

confidence: 99%

Successful tracheal intubation using fiberoptic bronchoscope via an I-gel™ supraglottic airway in a pediatric patient with Goldenhar syndrome -A case report-

Kim

Seo

Shim

et al. 2013

Korean J Anesthesiol

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The I-gel™ is a single-use supraglottic airway device introduced in 2007 which features a non-inflatable cuff and allows passage of a tracheal tube owing to its large diameter and short length of the airway tube. In this case, the authors experienced a difficult airway management on a 4-year-old boy with underlying Goldenhar syndrome who underwent a tonsillectomy. Intubation using a laryngoscope was unsuccessful at the first attempt. In the following attempt, we used the I-gel™ supraglottic airway for ventilation and were able to achieve successful intubation with a cuffed tube by using fiberoptic bronchoscope through the I-gel™ supraglottic airway. The authors suggest that I-gel™ is a useful device for ventilation and it has many advantages for tracheal intubation in pediatric patients with difficult airway.

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“…Difficult mask ventilation has been reported in Goldenhar syndrome secondary to soft-tissue cleft extending from the lateral aspect of the mouth to the mid-cheek on the affected side. Several case reports have described techniques for intubation in children with Goldenhar syndrome, including the Laryngeal Mask Airway, fiberoptic bronchoscopy (FOB), and tracheostomy with retrograde intubation [5][6][7].…”

Section: Discussionmentioning

confidence: 99%