Difficult tracheal intubation induced by maxillary distraction devices in craniosynostosis syndromes

Paediatric Anaesthesia
John RocheAndrew Heggie

Abstract

Difficult intubation occurred during anaesthesia for removal of maxillary distraction devices in five of seven children with syndromal craniosynostoses (four with Apert, two with Pfeiffer and one with Crouzon syndrome). Intubation was assessed in terms of laryngeal view and an established intubation difficulty score and had been straightforward before device insertion. Difficulty was induced by trismus due to device insertion and by increased maxillary prominence. This was compounded by preexisting mandibular hypoplasia. Cephalometric analysis, with each child acting as their own control, demonstrated anterior displacement of the maxilla and increased maxillary vertical height, as well as increased protuberance of the maxillary incisors. All five difficult tracheal intubations were associated with preoperative Mallampati scores of 3 or 4 and the nine straightforward intubations with scores of 1 or 2. Maximal interincisor distance was less than the lower 95% confidence limit for age in all five children who were difficult to intubate at the time of device removal. No child had a failed intubation, but all had significantly increased intubation difficulty. In view of the risks of trauma, hypoxia and aspiration associated with dif...Continue Reading

References

Jul 1, 1979·Oral Surgery, Oral Medicine, and Oral Pathology·J Stone, L B Kaban
Nov 1, 1992·Anesthesiology·J L Benumof
Sep 11, 1992·American Journal of Medical Genetics·M M Cohen, S Kreiborg
Jun 1, 1992·Anesthesiology·A I Brain
Jul 1, 1992·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·G Aiello, I Metcalf
Sep 1, 1991·Journal of Clinical Anesthesia·R S Holzman
May 1, 1990·The American Journal of Emergency Medicine·M R O'Leary
Jul 1, 1989·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·B H BuK Vargervik
Oct 1, 1986·Clinical Otolaryngology and Allied Sciences·K Tveterås, S Kristensen
Jul 1, 1985·Canadian Anaesthetists' Society Journal·S R MallampatiP L Liu
Nov 1, 1984·Anaesthesia·R S Cormack, J Lehane
Jul 1, 1983·The Annals of Otology, Rhinology, and Laryngology·S D Handler, T P Keon
Nov 1, 1995·Anesthesia and Analgesia·C R McCrory, D C Moriarty
Sep 1, 1993·American Journal of Diseases of Children·M M Cohen, S Kreiborg
Dec 1, 1995·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·J R MaltbyD P Archer
Jan 1, 1996·Paediatric Anaesthesia·F J Frei, W Ummenhofer
Sep 1, 1996·The Journal of Craniofacial Surgery·K IshiiK Vargervik
Feb 9, 1999·Plastic and Reconstructive Surgery·M G CedarsB A Toth
Nov 11, 1999·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·S M ConradR P White
Jan 13, 2000·Paediatric Anaesthesia·G P Morris, M G Cooper
Dec 21, 2000·Paediatric Anaesthesia·G BlancoF Ortiz-Monasterio

❮ Previous
Next ❯

Citations

Nov 16, 2010·Paediatric Anaesthesia·Sarah BarnettRobert Bingham
Dec 13, 2016·International Anesthesiology Clinics·Ingrid Fitz-James AntoineOren Tepper
Sep 12, 2015·The Journal of Craniofacial Surgery·Irene M J Mathijssen
Apr 12, 2011·Current Opinion in Anaesthesiology·David de Beer, Robert Bingham
Mar 3, 2010·Anaesthesia and Intensive Care·G E Brooker, M G Cooper

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Archives of Disease in Childhood. Education and Practice Edition
J TownshendD Campbell
Paediatric Anaesthesia
D S McDonaldA M Mackersie
European Journal of Anaesthesiology
A I CasadoP Oliva
© 2022 Meta ULC. All rights reserved