title: [Anesthesia Management for Primary Cleft Lip Closure in an Infant with Congenital Total Length Complete Tracheal Rings].
abstract: Complete tracheal ring causes congenital tracheal stenosis in neonates and infants. We have to prevent further tracheal stenosis in perioperative period. This is a case report of an infant with congenital tracheal stenosis due to complete tracheal ring who underwent primary cleft lip closure under general anesthesia. An 8 month-old boy was scheduled for bilateral cleft lip closure. His first operation at two months was canceled because of unsuccessful intubation in previous hospital. He came to our hospital to seek a second opinion. His CT scan showed long segment stenosis of the trachea below glottis. The tracheobronchial endoscopy showed complete tracheal rings 1.5 cm below glottis to the bifurcation. Considering his aspiration episode, we decided to do the cleft lip closure promptly after examinations. We chose an ID 3.0 mm RAE tracheal tube, which is commercially narrowest We intubated 2 cm below glottis, and confirmed that the tip did not touch narrowed trachea with endoscope. This tube was fixed in the center of the mandible and packed with gauze. He was discharged on 8 POD without complication. CT scan and its integrated 3 D image of the trachea were useful to understand the approximate structure. However endoscopic examination allowed more detailed structure-measurement below glottis.
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshinaga
authors.forename: Noriko
authors.initials: N
authors.lastname: Miyazawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hanzawa
authors.forename: Sakurako
authors.initials: S
authors.lastname: Miwa
authors.forename: Nami
authors.initials: N
authors.lastname: Oyama
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yamamoto
mesh_terms: D000768:Anesthesia, General; D002971:Cleft Lip / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000002:abnormalities* / Q000601:surgery