title: Percutaneous dilational tracheotomy for airway management in a newborn with Pierre-Robin syndrome and a glossopharyngeal web.
abstract: Pierre-Robin syndrome (PRS) is often associated with difficulty in endotracheal intubation. We present the use of percutaneous dilational tracheotomy (PDT) for airway management of a newborn with PRS and a glossopharyngeal web. A 2-day-old term newborn with PRS and severe obstructive  dyspnea was evaluated by the anesthesiology team for airway management. A direct laryngoscopy revealed a glossopharyngeal web extending from the base of the tongue to the posterior pharyngeal wall. The infant was spontaneously breathing through a 2 mm diameter fistula in the center of this  web. It was decided that endotracheal intubation was impossible, and a PDT was planned. The trachea of the newborn was cannulated, using a 20 gauge peripheral venous catheter and a 0.71 mm guide wire was introduced through this catheter. Using 5 French, 7 French, 9 French, and 11 French central  venous catheter kit dilators, staged tracheotomy stoma dilation was performed. By inserting a size 3.0 tracheotomy cannula, PDT was successfully completed in this newborn. This case describes the successful use of PDT for emergency airway management of a newborn with PRS and glossopharyngeal  web.
authors: Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey. araspirat@gmail.com
authors: Arash
authors: A
authors: Pirat
authors: Selim
authors: S
authors: Candan
authors: Aytekin
authors: A
authors: Unlükaplan
authors: Ozgür
authors: O
authors: Kömürcü
authors: Selim
authors: S
authors: Kuşlu
authors: Gülnaz
authors: G
authors: Arslan
mesh_terms: D058109:Airway Management; D004106:Dilatation; D004417:Dyspnea / Q000150:complications / Q000628:therapy; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D008334:Mandible / Q000601:surgery; D010027:Osteotomy; D010614:Pharynx / Q000473:pathology*; D010855:Pierre Robin Syndrome / Q000150:complications*; D014059:Tongue / Q000473:pathology*; D014140:Tracheotomy / Q000379:methods*