Laryngeal mask ventilation in patient with Treacher Collins syndrome

Abstract

Introduction: Treacher Collins syndrome (TCS) is an autosomal dominant disorder of craniofacial development.
Case description: A 5-year-old female patient (weight 16.8 kg, height 106 cm), ASA III, was admitted to our hospital for plastic surgery of the ears. The preoperative evaluation revealed no significant personal or family history for adverse reaction to anesthetics. A general anesthesia was scheduled for this patient. Fentanyl 0.05 mg, propofol 50 mg and succinylcholine 20 mg were administered for anesthesia induction. After intubation 2.5% sevoflurane was used for anesthesia maintenance. Additional 0.025 mg of fentanyl was administered for pain relief. The operation finished successfully within 55 min. The vital signs had been stable during the operation. Ventilation through the operation was successfully performed through laryngeal mask classic № 2.
Discussion: Management of patients with Treacher Collins syndrome is complicated and involves multiple disciplines working in concert to achieve a common outcome. When difficult intubation is anticipated, several alternatives to routine intubation are possible. In our study during maintenance of anesthesia, there was no evidence of instability of the LMA or increased contamination of the lower respiratory tract. During emergence from anesthesia, our results indicate that, compared with endotracheal anesthesia, airway management was easier using the LMA.
Conclusion: The laryngeal mask airway has become an important adjunct to airway management since its introduction. Ventilation through LMA can be safely used during operations in patients with Treacher Collins syndrome.