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pierre robin syndrome intubation

Rebecca M Barr, Sabina A Khan, Manish N Shah, Soham Roy, John F Teichgraeber, Matthew R Greives
Many patients with Pierre Robin sequence (PRS) have associated birth defects, most commonly in association with abnormalities in bone or cartilage formation. Depending on severity, treatment of PRS ranges from nonoperative management with prone positioning to surgical intervention such as distraction osteogenesis. Generally, if a surgical approach is needed, these patients undergo nasal endoscopy or direct laryngoscopy with their intubation, which puts the cervical spine in a position of extreme extension. The authors present a patient with syndromic PRS secondary to Sticklers syndrome, with a cervical abnormality diagnosed with three-dimensional computed tomography and further evaluated with dynamic lateral plain x-rays to assess cervical instability...
October 2016: Journal of Craniofacial Surgery
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No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Masashi Fujii, Kazuya Tachibana, Muneyuki Takeuchi, Juntaro Nishio, Keiko Kinouchi
BACKGROUND: Glossopexy (tongue-lip adhesion) is a procedure in which the tongue is anchored to the lower lip and mandible to relieve the upper airway obstruction mainly in infants with Pierre Robin sequence. Infants suffering from severe upper airway obstruction and feeding difficulties due to glossoptosis are the candidates for this procedure and are predicted to demonstrate difficult airway and difficult intubation. METHODS: We retrospectively examined the perioperative management of 19 infants undergoing glossopexy procedure at our institution from 1992 to 2010...
August 2015: Paediatric Anaesthesia
Haci Ahmet Alici, Mehmet Cesur, Rahmi Ors, Ayhan Tastekin, Yusuf Tuzun
Babies with Pierre Robin syndrome have serious life-threatening risks because of acute respiratory distress and difficult airway management. It is difficult to perform endotracheal intubation in these babies for general anesthesia. We present successful insertion of laryngeal mask airway in a neonate with typical clinical features of Pierre-Robin syndrome using a size 1 laryngeal mask airway for a ventriculoperitoneal shunt operation. The patient had micrognathia, glossoptosis with cleft palate, and partial trismus...
December 2008: Eurasian Journal of Medicine
Hidetaka Iwai, Hideyuki Mouri, Yoshihiro Hirabayashi, Mamoru Takeuchi
We report a successful use of GlideScope AVL in a pediatric patient with Pierre Robin syndrome. A 36-day-old boy weighing 2.8 kg with Pierre Robin syndrome presented for tracheostomy after several weeks of trial airway management in prone position, who had failed to relieve his obstructive apnea. The Pentax-AWS videolaryngoscope equipped with the neonate Introck could not visualize his glottic opening. The GlideScope AVL single-use video laryngoscope equipping the #1 stat captured the view of the vocal cords...
June 2014: Masui. the Japanese Journal of Anesthesiology
Mehmet K Kanburoglu, Mehmet N Cizmeci, Ahmet Z Akelma, Nebil Ark, Mustafa M Tatli
Conventional intubation for pulmonary management in children with a difficult airway may be very challenging even in skilled hands. Rapid advancements in respiratory care have reduced the incidence of difficult tracheal intubation and the incidence of complications have decreased accordingly. However, serious unexpected complications still occur in some patients today. Herein, we describe a syndromic newborn infant with a difficult airway who experienced migration of the endotracheal tube into the esophagus after displacement of the tube connector...
June 2014: Archivos Argentinos de Pediatría
Yongsuk Kim, Jeong Eun Kim, Da Hye Jeong, Jaemin Lee
Patients with Pierre Robin syndrome are characterized by micrognathia, retrognathia, glossoptosis, and respiratory obstruction and are prone to have a difficult-to-intubate airway. The McGrath® MAC video laryngoscope provides a better view of the glottis than a Macintosh laryngoscope, but it is not easy to insert an endotracheal tube through the vocal cords because a video laryngoscope has a much greater curvature than that of a conventional direct laryngoscope and an endotracheal tube has a different curvature...
April 2014: Korean Journal of Anesthesiology
Kemal T Saracoglu, Zeynep Eti, Ayse D Kavas, Tumay Umuroglu
BACKGROUND: It is still controversial which laryngoscope may be a better option in unanticipated difficult airway in pediatric patients. The aim of the present study was to compare two direct and two video-assisted laryngoscope devices for the management of difficult pediatric airway. METHODS: Forty-five anesthesiology residents and nurse anesthetists participated in the study. Macintosh, Miller, Storz Miller, and McGrath Mac curved laryngoscopes were used for tracheal intubation of 3-6-month Airsim Pierre Robin manikin...
March 2014: Paediatric Anaesthesia
Kariuki P Murage, Sunil S Tholpady, Michael Friel, Robert J Havlik, Roberto L Flores
UNLABELLED: Mandibular distraction osteogenesis is an established technique used to treat infants with Pierre Robin sequence associated with severe airway obstruction. The authors present a 7-year retrospective review of all patients with Pierre Robin sequence treated with mandibular distraction osteogenesis. Recorded variables included improvements in apnea/hypopnea index and postintervention tracheostomy. Multiple preoperative variables were assessed for association with successful mandibular distraction osteogenesis or tracheostomy...
August 2013: Plastic and Reconstructive Surgery
Akkharawat Sinkueakunkit, Bowornsilp Chowchuen, Chonrat Kantanabat, Wimonrat Sriraj, Malinee Wongswadiwat, Piyaporn Bunsangjaroen, Sarinya Chantawong, Aumjit Wittayapairoj
BACKGROUND: The challenge for anesthetic management for children with craniofacial deformities is to develop comprehensive anesthetic care. The purposes of this study were to review the authors' experience with airway management and ventilator support and evaluate outcome during the perioperative period among these patients at the Tawanchai Center, Srinagarind Hospital. METHODS: A retrospective (2005-2009), descriptive study was conducted to analyze the anesthetic management and perioperative outcomes among children with craniofacial deformities at the Tawanchai Center...
June 2013: Pediatrics International: Official Journal of the Japan Pediatric Society
Eun Kyeong Choi, Ji Eun Kim, Sa Rah Soh, Chang Kyun Kim, Wyun Kon Park
The case of a 33-day-old boy with Pierre Robin syndrome using a Cook® airway exchange catheter in laryngeal mask airway-guided fiberoptic intubation is presented. After induction with sevoflurane, classical reusable laryngeal mask airway (LMA) #1 was inserted and ultrathin fiberoptic bronchoscope (FOB) was passed through. A Cook® airway exchange catheter (1.6 mm ID, 2.7 mm OD) was passed through the LMA under the guidance of the FOB but failed to enter the trachea despite many trials. Then, an endotracheal tube (3...
February 2013: Korean Journal of Anesthesiology
Sara C Handley, Nicholas S Mader, James D Sidman, Andrew R Scott
OBJECTIVE: To determine which factors present in the neonatal period may predict subsequent need for surgical intervention in infants with micrognathia. STUDY DESIGN: Case series with chart review. SETTING: Two, urban, tertiary pediatric hospitals. SUBJECTS AND METHODS: The otolaryngology databases from 2 institutions were queried for the diagnosis of micrognathia over a 10-year period, and 123 infants were identified (101 with Pierre Robin sequence and 21 with micrognathia without cleft palate)...
May 2013: Otolaryngology—Head and Neck Surgery
Geoff Frawley, Ainsley Espenell, Peter Howe, Jocelyn Shand, Andrew Heggie
OBJECTIVES: To document the incidence of difficult intubation following mandibular distraction osteogenesis (MDO) in children with severe mandibular hypoplasia. BACKGROUND: Syndromes associated with significant mandibular hypoplasia, especially Pierre Robin sequence, provide a challenge in airway management both in and out of the operating room. Mandibular advancement using mandibular distraction osteogenesis devices has been used in infants in an attempt to reduce the incidence of acute life-threatening airway obstruction...
April 2013: Paediatric Anaesthesia
Sze-Ying Thong, Theodore Gar-Ling Wong
The Bonfils Retromolar Intubation Fiberscope is a rigid, straight fiberoptic device with a 40-degree curved tip, which facilitates targeted intubation. Bonfils, using a retromolar approach to intubate tracheas of children with Pierre Robin syndrome, was first described in 1983. After an initial steep learning curve, the Bonfils becomes a useful device in the management of normal and difficult airways. The advantages lie in its performance as an optical intubating stylet, which allows visualization from the tip of the endotracheal tube during intubation...
October 2012: Anesthesia and Analgesia
Xiao-hua Shi, Ning Yin, Jian Fei, Hong-qiang Huang, Wen-xu Jiang
OBJECTIVE: To assess the difficult airways preoperatively in neonates with Pierre Robin sequence (PRS). METHODS: A total of 18 newborn PRS with difficult intubation were evaluated with the assessment grade. The scores were based upon clinical observation, weight gain, airway obstruction and Cormack-Lehane classification. RESULTS: A total of 14 neonates (77%) had medium (n = 8) and severe (n = 6) airway obstruction. And 89% (n = 16) failed to display glottis and unsuccessful tracheal intubation (50%)...
April 3, 2012: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Alexander P Marston, Timothy A Lander, Robert J Tibesar, James D Sidman
OBJECTIVES/HYPOTHESIS: To review airway management in Pierre Robin sequence (PRS) newborns undergoing general anesthesia and to determine if endotracheal intubation is safe in this population. STUDY DESIGN: Case series and retrospective chart review at a tertiary children's hospital. METHODS: PRS newborns who underwent endotracheal intubation or other airway intervention before 3 months of age between January 2000 and July 2011 were identified from a pediatric otolaryngology practice database...
June 2012: Laryngoscope
Bowornsilp Chowchuen, Kamonwan Jenwitheesuk, Prathana Chowchuen, Benjamas Prathanee
BACKGROUND: The challenges for the management of Pierre Robin Sequence (PRS) are the evaluation and management of airway and feeding difficulty from glossoptosis and associated cleft palate. OBJECTIVE: To present the clinical findings, management, outcome and the role of early distraction osteogenesis in patients with PRS. MATERIAL AND METHOD: The medical records were reviewed of patients with PRS seen and managed by the authors at Srinagarind Hospital, Khon Kaen University between 2001 and 2011...
December 2011: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Shelly Abramowicz, Janine D Bacic, John B Mulliken, Gary F Rogers
BACKGROUND: The GILLS score consists of gastroesophageal reflux disease, preoperative intubation, late surgical intervention, low birth weight, and syndromic diagnosis. The purpose of this study was to test the validity of the GILLS score in predicting success of tongue-lip adhesion (TLA) in managing Robin sequence. MATERIALS AND METHODS: Infants with Robin sequence were included in the study if they had a TLA for airway compromise subsequent to formulation of the GILLS scoring system, that is, they were not included in the original GILLS analysis...
March 2012: Journal of Craniofacial Surgery
Isabelle Arteau-Gauthier, Jacques E Leclerc, Audrey Godbout
OBJECTIVE: To find predictors of a difficult intubation in infants with an isolated or a syndromic cleft lip/palate. STUDY DESIGN: Retrospective review: single-blind trial. SETTINGS: Tertiary care centre. METHODS: A total of 145 infants born with cleft lip/palate were enrolled. Three clinical and seven lip/palate anatomic parameters were evaluated. The grade of intubation was determined by the anesthesiologist at the time of the labioplasty/staphylorrhaphy surgery at 3 and 10 months, respectively...
October 2011: Journal of Otolaryngology—Head & Neck Surgery
Reza Jarrahy
Symptomatic micrognathia, as seen in syndromic and isolated presentations of the Robin sequence (RS), can pose immediate an ongoing threats to the well-being of neonates. Upper airway obstruction can manifest as acute respiratory insufficiency requiring postpartum intubation and mechanical ventilation or as a mild irregularity in the oropharyngeal airflow that can be managed by positioning the newborn in a prone or decubitus position. Clinically significant micrognathia is often accompanied by some degree of feeding difficulty, obstructive sleep apnea, and gastroesophageal reflux disease, all of which should be evaluated by a multidisciplinary team of specialists before a definitive treatment plan is formulated...
January 2012: Journal of Craniofacial Surgery
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