Managing the difficult airway in the syndromic child

Raj, Diana; Luginbuehl, Igor

doi:10.1093/bjaceaccp/mku004

Cited by 49 publications

(43 citation statements)

References 16 publications

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“…Certain predictors of difficult airway are obvious such as facial dysmorphysm, limited mouth opening, restricted mobility of the TMJ, and limited sub mandibular space because of retrognathia and mandibular hypoplasia. Rather, it is an anticipated difficult airway with little or nil mouth opening [28,34]. Although literature does mention protocols for airway management in syndromic children, there is no mention of children with TMJ ankylosis [23,35].…”

Section: Review Of Methods Used For Securing Airwaymentioning

confidence: 99%

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Management of Young Patients with Temporomandibular Joint Ankylosis—a Surgical and Anesthetic Challenge

et al. 2016

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Temporomandibular joint ankylosis is a unique disease where fracture of the mandibular condyle or any other cause leading to ankylosis of the joint can lead to multiple problems if not detected and treated early. If affected in early years of life, it may cause facial dysmorphism, restricted mouth opening, and difficulty in eating, speech, and sleep. Early surgery and physiotherapy can restore the joint function to a great extent. Anesthetizing a pediatric patient with this disorder is a definite challenge which needs expertise in difficult airway management.

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Section: Review Of Methods Used For Securing Airwaymentioning

confidence: 99%

“…Limited data is available to the real incidence of difficult airway management in pediatric patients [28]. The incidence of difficult tracheal intubation was derived to be around 1.2 to 9 % in pediatric population [29,30].…”

Section: Airway Managementmentioning

confidence: 99%

Management of Young Patients with Temporomandibular Joint Ankylosis—a Surgical and Anesthetic Challenge

et al. 2016

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“…It is advisable to have a fiberoptic bronchoscope available. Consider the need for preoperative tracheostomy . As the patient grows, there is more room for the tongue; however, many patients require (partial) glossectomy (Figure )…”

Section: Beckwith‐wiedemann Syndromementioning

confidence: 99%

Pediatric syndromes with noncraniofacial anomalies impacting the airways

Oliveira¹

2020

Pediatric Anesthesia

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Syndromes with noncraniofacial abnormalities can be a real challenge in terms of airway management. The key to success is effective preparation, presence of personnel with expertise in difficult pediatric airway management, regular training and familiarity with difficult intubation equipment, and teamwork. Considering that there are a very large number of syndromes, with variable phenotypic expression, the management strategy of every case will be dictated by the anatomical and functional airway as assessed on physical examination and subsidiary examinations before induction of anesthesia.

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“…This airway obstruction is usually readily relieved with insertion of an oral or nasopharyngeal airway. In approximately two‐thirds of patients with Apert syndrome, fused cervical vertebrae are present which may make laryngeal exposure during direct laryngoscopy more difficult . Cervical fusions have also been found to occur in 25% of Crouzon patients; however, fusion involving C 2 ‐C 3 is most common in Crouzon, whereas C 5 ‐C 6 fusion alone or in combination with other fusions is most common in Apert syndrome .…”

Section: Craniosynostosismentioning

confidence: 99%

Craniofacial surgery and specific airway problems

Garcia‐Marcinkiewicz

Stricker

2019

Pediatric Anesthesia

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Infants and children undergoing craniofacial surgery may present with a wide range of diseases and conditions posing an array of challenges to the anesthesiologist. Optimal perioperative care requires an understanding of these diseases and their impact on airway and anesthetic management. For those children with anomalies affecting airway anatomy, soft tissues of the head and neck, or skeletal mobility, advanced airway management techniques (ie, modalities other than direct laryngoscopy) may be required to secure the airway. Additionally, some craniofacial surgical procedures have direct implications on airway management, such as with Le Fort III midface advancement involving halo distractor application, where the distractor device precludes facemask ventilation. For all of these patients, the anesthetic and airway management plans must be tailored to the surgery being performed, the patient's specific conditions, and take into consideration all phases of perioperative care. In this review, we present some of the more commonly encountered craniofacial abnormalities affecting airway management.

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Managing the difficult airway in the syndromic child

Cited by 49 publications

References 16 publications

Management of Young Patients with Temporomandibular Joint Ankylosis—a Surgical and Anesthetic Challenge

Management of Young Patients with Temporomandibular Joint Ankylosis—a Surgical and Anesthetic Challenge

Pediatric syndromes with noncraniofacial anomalies impacting the airways

Craniofacial surgery and specific airway problems

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