Alternative Methods for Nasotracheal Intubation and Extubation in a Patient With Apert Syndrome

Abstract

Apert syndrome is a rare autosomal dominant disorder characterized by craniofacial abnormalities, craniosynostosis and syndactyly. Nasotracheal intubation for a patient with Apert syndrome can be a challenge because of abnormal facial anatomy. We experienced the anesthetic management of a patient with Apert syndrome who underwent partial resection of mandible and cleft palate repair with nasotracheal intubation. Nasotracheal intubation using a gastric tube and extubation using an airway exchange catheter proved useful in this case of airway compromise.

Sudden Tachycardia Due to Submucosal Migration of an Epinephrine-Soaked Swab During Nasal Intubation

“…The usefulness of almost identical methods using a nasogastric tube has been reported elsewhere. 6,7 Since the suction catheter used for tracheobronchial toilet in our routine clinical practice has insufficient length for this purpose, the TT was cut and shortened to facilitate intubation by this method. Since the connecter portion of the catheter might cause friction against the inside of the TT, that portion was also cut and removed.…”