Difficult airway in a child with spinal muscular atrophy type I

Paediatric Anaesthesia
Hajime ArimaHirotada Katsuya

Abstract

Spinal muscular atrophy (SMA) type I is a relatively common inherited neuromuscular disease of hypotonic newborns, but is not associated with craniofacial abnormalities. There is nothing in the literature about difficult intubation in patients affected by this disease. We report a case of 34-month-old girl with SMA type I who was scheduled for emergency endoscopic laser treatment of tracheal stenosis caused by granulations. Tracheostomy was performed at 17 months of age and before this, the orotracheal tube was changed periodically without difficulty. For this laser treatment, orotracheal intubation was required. Preoperative physical examination revealed micrognathia and class II malocclusion. Opening her mouth was not difficult. Although difficult orotracheal intubation was predictable, we attempted to intubate her trachea as usual, but could not visualize the epiglottis. We decided to proceed with retrograde intubation, one of the standard techniques employed in a child with a difficult airway, via the tracheostome. A feeding nasogastric catheter was used as a guide catheter, and our strategy was successful. In this study we report a case of difficult airway in a child with SMA type I. The relationship between SMA type I wit...Continue Reading

References

Apr 1, 1989·Anesthesia and Analgesia·B GuptaJ Mendenhall
Mar 1, 1995·Anaesthesia·T SuhasiniS M Rao
Jul 1, 1996·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·H J PrzybyloS C Hall

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Citations

Dec 9, 2008·Emergency Medicine Clinics of North America·David Burbulys, Kianusch Kiai
Sep 9, 2009·Anaesthesia·S S Dhara
Jun 30, 2009·Paediatric Anaesthesia·Robert J GrahamNavil F Sethna
Aug 23, 2008·Paediatric Anaesthesia·Rajeev Sharma
Apr 23, 2013·Paediatric Anaesthesia·Gunilla Islander

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