Flexible bronchoscopy combined with videolaryngoscope for tracheal intubation in a child with Hunter syndrome: a case report

Faisal Shamim, Amber Gulamani, Abdullah Nisar, Saima Rashid, Humayun kaleem Siddiqui
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引用次数: 0

Abstract

Hunter syndrome (mucopolysaccharidosis type II) has the highest reported prevalence of difficult tracheal intubation among the seven known types of mucopolysaccharidoses. Despite improved difficult airway guidelines and equipment, conventional approaches may fail in some cases. A 10-year-old child with Hunter syndrome, was scheduled for multiple dental extractions. On the first visit, failed intubation was declared as per Difficult Airway Society guidelines in the surgical day-care suite of our institute and the procedure was postponed. The case was then planned to be handled in the main operating room with additional preparation and input from the paediatric otolaryngologist for possible tracheostomy, paediatric intensive care for postoperative need for ventilation, and difficult airway resource faculty for an unconventional approach—videolaryngoscope combined with fibreoptic bronchoscope—which resulted in safe administration of anaesthesia. This case illustrates the importance of meticulous planning in the management of previously failed airway.
柔性支气管镜联合视频喉镜治疗亨特综合征患儿气管插管1例
在已知的7种粘多糖病中,亨特综合征(粘多糖病II型)的气管插管困难发生率最高。尽管改进了困难气道指南和设备,但传统方法在某些情况下可能会失败。一个患有亨特综合症的10岁孩子,被安排了多次拔牙。在第一次就诊时,根据困难气道协会的指导方针,在我们研究所的外科日间护理套房宣布插管失败,并推迟了手术。然后计划在主手术室处理该病例,儿科耳鼻喉科医生为可能的气管造口术做额外的准备和输入,儿科重症监护手术后需要通气,以及难以使用非常规方法的气道资源-视频喉镜联合纤维支气管镜-这导致麻醉的安全给药。本病例说明了在先前气道失败的管理中细致规划的重要性。
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