Zbrinjavanje dišnoga puta uz direktnu laringoskopiju u djeteta s Goldenharovim sindromom

Abstract

Goldenhar syndrome, also known as oculoauriculovertebral dysplasia, is a rare congenital condition characterized by facial, cranial, vertebral, ocular, auricular and cardiac abnormalities. This syndrome is associated with hemifacial microsomia due to inadequate growth of the mandible and vertebral anomaly of the cervical part of the spine. For anesthesiologists, airway management is of great interest because of facial and oral abnormalities such as mandibular hypoplasia and limitation of neck movement. Considering different conditions of Goldenhar syndrome, every patient should be preoperatively evaluated in order to make the plan for the anticipated difficult airway management. We report a case of a 2.5-year-old boy undergoing palatoplasty, who required general anesthesia and orotracheal intubation. Our decision to intubate with direct laryngoscopy and with slight external pressure on the larynx proved successful.Goldenharov sindrom je kongenitalni sindrom s općom manifestacijom hemifacijalne mikrosomije zbog nedostatnog sazrijevanja mandibule i anomalijama vratne kralježnice. Svaki anesteziolog treba znati da se u djece s Goldenharovim sindromom predviđa otežano zbrinjavanje dišnoga puta, otežana ventilacija i intubacija. Sindromi se u djece prezentiraju u različitom opsegu. Stoga svako dijete kod kojega je dijagnosticirana malformacija pogotovo dišnoga puta treba detaljno pregledati i odlučiti na koji način pristupiti zbrinjavanju dišnoga puta. U ovom prikazu slučaja dvoipogodišnjeg dječaka zbog zahvata plastike mekoga nepca trebali smo intubirati orotrahealnim putem. Dječak je intubiran direktnom laringoskopijom uz lagani vanjski pritisak na larinks