Difficult tracheal intubation in patients with retinoblastoma caused by 13q deficiency.
Anesthetic management of retinoblastoma patients is unremarkable in most cases. Patients are most often babies and laryngoscopic procedures for intubation are usually easy. However, we recently experienced two cases with retinoblastoma with whom tracheal intubation was accomplished with difficulty. We report the two cases with a review of all 5-year records of retinoblastoma (rbl) in our institution. The cases we experienced recently were all patients with rbl with deletion of the long arm of thirteenth chromosome (13q-). In the 5-year review, the incidence of the difficult intubation was significantly higher (P < 0.05) in rbl with 13q- (4/11) than in rbl without 13q- (0/147). In our experience macroglossia was noted for the difficulty in the intubation. We assume that some patients with rbl will be cases of difficult intubation even to cannot ventilate-cannot intubate level when the results of their chromosomal analysis show a deletion on the thirteenth chromosome.
Department of Anesthesia, National Cancer Center Hospital, Tokyo, Japan. toshis@nms.ac.jp
T
T
Saito
A
A
Kaneko
Y
Y
Muramatsu
M
M
Inomata
Y
Y
Murakami
S
S
Den
J
J
Gotanda
N
N
Yokokawa
K
K
Hiraga
E
E
Carney
P A
PA
Lönnqvist
C
C
Carlsson
D000758:Anesthesia / Q000379:methods; D002882:Chromosomes, Human, Pair 13; D017353:Gene Deletion; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D008297:Male; D019572:Retinal Neoplasms / Q000235:genetics*; D012175:Retinoblastoma / Q000235:genetics*