Orotracheal intubation with an AirWay Scope in a patient with Treacher Collins syndrome.
Treacher Collins syndrome (TCS) is a congenital malformation of craniofacial development; in these patients conventional direct laryngoscopy is very difficult and often unsuccessful because of the upper airway malformation. A 20-year-old man with TCS was scheduled for elective tympanoplasty. The patient showed the characteristic facial appearance of TCS, and a difficult airway was anticipated. After careful anesthesia induction, direct laryngoscopy with Macintosh blade no. 4 of a direct laryngoscope failed to visualize the epiglottis, even with cricoid pressure, resulting in a grade 4 Cormack and Lehane view. Next, the AirWay Scope was easily inserted, and his glottic opening was clearly visualized. An 8.0-mm-internal-diameter tracheal tube was then advanced into the trachea without any difficulty. The AirWay Scope is a very useful airway device for orotracheal intubation; it provides an excellent view of the glottis without requiring alignment of the oral, pharyngeal, and laryngeal axes, and appears to be promising for use in patients with a difficult airway.
Iguchi
Hironobu
H
Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Nagoya, Japan.
Sasano
Nobuko
N
So
Minhye
M
Hirate
Hiroyuki
H
Sasano
Hiroshi
H
Katsuya
Hirotada
H
D000328:Adult; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008342:Mandibulofacial Dysostosis / Q000601:surgery*; D016896:Treatment Outcome; D014433:Tympanoplasty