Airway management in children with hemifacial microsomia: a restropective study of 311 cases

作者：Jin Xu, Xiaoming Deng, Fuxia Yan · 发表于：BMC Anesthesiology · 年份：2020 · DOI：10.1186/s12871-020-01038-2 · 被引用次数：12 · 研究领域：Craniofacial Disorders and Treatments、Cleft Lip and Palate Research、Congenital Ear and Nasal Anomalies

BACKGROUND: Hemifacial microsomia (HFM) is a congenital craniofacial malformation which is associated with difficult airway. Anesthesiologists may experience difficult intubation in children with HFM. Mandibular distraction could increase the length of the mandible. Theoretically, it should be advantageous to laryngeal view during tracheal intubation. This study reviewed airway management in children with HFM, assessed the efficiency of direct laryngoscopy versus airway-visualizing equipment during the tracheal intubation and determined whether mandibular distraction could improve the laryngoscopic view in children with HFM. METHODS: A retrospective review of cases involving children with HFM aged 5 to 17 years old underwent anesthesia from December 2016 to April 2019 at a single center was performed. The demographic data, preoperative airway assessments, procedure type, anesthetic technique, method of airway management, anesthetists' comments on mask ventilation, laryngoscopy and intubation parameters were collected. RESULTS: At last, 136 HFM children entered this study, a total of 311 anesthesia procedures were completed during the study period. Face mask ventilation was possible for most of children except 1 child (bilateral involvement) required two practitioners. The success rates of intubation for the primary video laryngoscopy and fibroscopy were both 100%, but 79.5% for direct laryngoscopy (P < 0.001). 95 (38.9%) children who had difficult laryngoscopic view (DLV) wer...