title: Difficult airway in a child with severe dystonia.
abstract: OBJECTIVE
  To describe the management of a 15-year-old girl with repeated life-threatening complications of her tracheostomy secondary to muscle dystonia and thoracolumbocervical lordosis.
  
  
  METHODS
  This paper reports a retrospective case review.
  
  
  RESULTS
  Regular microlaryngoscopy and bronchoscopy, treatment with systemic steroids and a soft tracheostomy tube, in addition to better control of the dystonia, resulted in control of the patient's airway. This minimised tracheal inflammation and granulation tissue formation.
  
  
  CONCLUSIONS
  The need for a tracheostomy in patients with thoracolumbocervical lordosis and severe dystonia should be considered only after all other options of airway management have been explored. Every attempt should be made to minimise tracheal trauma caused by excessive movement of a tracheostomy tube.
authors: ENT Department, Evelina Children's Hospital, London, UK. nnekaeze@yahoo.co.uk
authors: N
authors: N
authors: Eze
authors: G A
authors: GA
authors: Morrison
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology; D004421:Dystonia / Q000150:complications*; D005260:Female; D006097:Granulation Tissue; D006801:Humans; D012189:Retrospective Studies; D055090:Tracheomalacia / Q000628:therapy*; D014139:Tracheostomy / Q000009:adverse effects* / Q000295:instrumentation