title: Case report: airway and concurrent hemodynamic management in a neonate with oculo-auriculo-vertebral (Goldenhar) syndrome, severe cervical scoliosis, interrupted aortic arch, multiple ventricular septal defects, and an unstable cervical spine.
abstract: We report the challenging case of a 1-week-old, term, 2.4 kg neonate with Goldenhar syndrome (including microcephaly, left microtia, left facial palsy, dextro-scoliosis of the cervical spine, and cervico-thoracic levoscoliosis), multiple ventricular septal defects, a type B interrupted aortic arch, a large patent ductus arteriosis, and radiographic and clinical signs concerning for an unstable cervical spine. Our anesthesia team was consulted for perioperative management of this patient during her surgical repair. This case report describes the use of the Air-Q size 1 laryngeal airway (LA) to assist fiberoptic intubation in an ASA 4 neonate with cardiac disease, an anticipated difficult airway with the addition of an unstable cervical spine, as well as the anesthetic techniques used to maintain hemodynamic stability while the airway was secured.
authors: Department of Anesthesiology, Stanford University School of Medicine, Palo Alto, CA 94305, USA. dchar@stanford.edu
authors: Danton S
authors: DS
authors: Char
authors: Melanie
authors: M
authors: Gipp
authors: M Gail
authors: MG
authors: Boltz
authors: Glyn D
authors: GD
authors: Williams
mesh_terms: D058109:Airway Management; D001015:Aortic Arch Syndromes / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000473:pathology; D005260:Female; D006053:Goldenhar Syndrome / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D006345:Heart Septal Defects, Ventricular / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D007593:Joint Instability / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D012600:Scoliosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D013131:Spine / Q000473:pathology; D014057:Tomography, X-Ray Computed