Anesthesia for elective bilateral sagittal slip osteotomy of the mandible and genioplasty in a young man with Klippel-Feil syndrome, Sprengel deformity, and mandibular prognathism
10.17245/jdapm.2019.19.5.307
- Author:
Rathna PARAMASWAMY
1
Author Information
1. Department of Anaesthesiology, Saveetha Medical College and Hospital, Chennai, India. drrathna86@yahoo.co.in
- Publication Type:Case Report
- Keywords:
Klippel-Feil Syndrome;
Kyphoscoliosis;
Mandibular Prognathism;
Orthognathic Surgery;
Sprengel Deformity;
Submental
- MeSH:
Adolescent;
Anesthesia;
Cervical Vertebrae;
Congenital Abnormalities;
Female;
Genioplasty;
Hair;
Head;
Humans;
Hypertrophy;
Intubation;
Klippel-Feil Syndrome;
Lung Diseases;
Mandible;
Nasal Septum;
Neck;
Open Bite;
Orthognathic Surgery;
Osteotomy;
Prognathism;
Scapula;
Spinal Injuries;
Surgery, Oral;
Turbinates
- From:Journal of Dental Anesthesia and Pain Medicine
2019;19(5):307-312
- CountryRepublic of Korea
- Language:English
-
Abstract:
Klippel-Feil syndrome is characterized by congenital fusion of two or more cervical vertebrae, a low hair line at the back of the head, restricted neck mobility, and other congenital anomalies. We report a 16-year-old young man with Klippel-Feil syndrome, Sprengel deformity of the right scapula, thoracic kyphoscoliosis, and mandibular prognathism with an anterior open bite. He was treated with orthodontic treatment and maxillofacial surgery. An anticipated difficult airway due to a short neck with restricted neck movements and extrinsic restrictive lung disease due to severe thoracic kyphoscoliosis increased his anesthesia risk. Due to his deviated nasal septum and contralateral inferior turbinate hypertrophy, we chose awake fiber optic orotracheal intubation followed by submental intubation. Considering the cervical vertebral fusion, he was carefully positioned during surgery to avoid potential spinal injury. He recovered well and his postoperative course was uneventful.
