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Anaesthetic Management in a Rare Case of Bird Face Deformity, Hypertrophied Adenoids and Temporomandibular Joint Ankylosis


Affiliations
1 Department of Anaesthesia, Government Medical College, Amritsar, Punjab, India
2 Department of Anaesthesia, Government Dental College, Amritsar, Punjab, India
 

Various methods have been described for nasal intubation in children with temporomandibular joint ankylosis with limited mouth opening. As younger children are uncooperative, they require intubation under anaesthesia. When associated with hypertrophied adenoid, there is high risk of airway obstruction and bleeding into the unprotected airway resulting in laryngospasm and/ or bronchospasm. We here describe successful intubation in a paediatric patient in whom the airway was obstructed with hypertrophic adenoids.


Keywords

Bronchospasm, Fibreoptic Laryngoscope, Obstructive Sleep Apnoea, Temporomandibular Joint.
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  • Mohan K, Rupa LM, Murthy GKS, Greeshma PG, Bhavana U. Anaesthesia for TMJ ankylosis with the use of TIVA, followed by endotracheal intubation. Journal of Clinical and Diagnostic Research 2012;6:1765–7.

  • Ramkumar V. Preparation of the patient and the airway for awake intubation. Indian J Anaesth 2011;55:442–7.

  • Kulkarni J, Shah K, Khan AAG, Khaire S. Anaesthetic management of temporomandibular joint ankylosis without fibrotic bronchoscope- A review of 31 cases. IOSR Journal of Dental and Medical Sciences 2013;8:50–4.

  • Weisman H, Wes TW, Elam JO. Use of double nasopharyngeal airways in anaesthesia. Anaesth Analg 1969;48:356–8.

  • Varughese I, Varughese PI, Soman T, Mathew J. Fluroscopic assisted airway intubation in temporomandibular joint ankylosis: A novel technique. Saudi J Anaesth 2011;5:226–8.

  • Kang JM, Lee KW, Kim DO, Yi JW. Airway management of an ankylosing spondylitis patient with severe temporomandibular joint ankylosis and impossible mouth opening. Korean J Anesthesiol 2013;64:84–6.

  • Kamat S, Raju M, Gupta R, Kamat S. Modified technique of retrograde intubation in tmj ankylosis. Indian J Anaesth 2008;52:196–8.

  • Pattinson KT. Opioids and the control of respiration. Br J Anaesth 2008;100:747–58.


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  • Anaesthetic Management in a Rare Case of Bird Face Deformity, Hypertrophied Adenoids and Temporomandibular Joint Ankylosis

Abstract Views: 305  |  PDF Views: 94

Authors

Joginder Pal Attri
Department of Anaesthesia, Government Medical College, Amritsar, Punjab, India
Ranjana Khetarpal
Department of Anaesthesia, Government Medical College, Amritsar, Punjab, India
Vega Makkar
Department of Anaesthesia, Government Medical College, Amritsar, Punjab, India
Rajinder Pal Singh
Department of Anaesthesia, Government Dental College, Amritsar, Punjab, India

Abstract


Various methods have been described for nasal intubation in children with temporomandibular joint ankylosis with limited mouth opening. As younger children are uncooperative, they require intubation under anaesthesia. When associated with hypertrophied adenoid, there is high risk of airway obstruction and bleeding into the unprotected airway resulting in laryngospasm and/ or bronchospasm. We here describe successful intubation in a paediatric patient in whom the airway was obstructed with hypertrophic adenoids.


Keywords


Bronchospasm, Fibreoptic Laryngoscope, Obstructive Sleep Apnoea, Temporomandibular Joint.

References