Nasotracheal Intubation in a Pediatric Patient with Temporomandibular Joint Ankylosis
Journal Title: Scholars Journal of Medical Case Reports - Year 2015, Vol 3, Issue 10
Abstract
Temporomandibular joint (TME) ankylosis is disease that occurs due to the attachment of mandibula to the base of the skull and restricts opening of the mouth and causes problems in air way management. In this report, in a pediatric case in whom unilateral TME ankylosis developed after traffic accident and who had mouth opening of 1cm. and our nasotracheal intubation experience with the help of a videolaryngoscope is presented. A 11 year old girl at the weight of 34kg. had limitation of mouth opening following a traffic accident and Ear Nose Throat (ENT) department diagnosed her with unilateral TME ankylosis and operation was planned. Tiromental distance was 2cm and sternomental distance was 4,5. Patient was evaluated as difficult intubation and intubation with laryngoscope was planned. Mallampati score was 4, and ASA score was 2. Induction was made with propofol without losing spontaneous respiration. Cormac Lehane grade was found to be II and patient was intubated nasotracheally with 5.5. mm tube using videolaryngoscope. Following the surgical procedure lasting three hours, a successful extubation procedure was carried out using sugammadex. In the prediction of difficult airway, short and muscular neck, low set mandibula, protruding maxilla incisiors, movement restriction in temperomandibular joint, longer alveolar mental distance, cercial movement limitation, mouth opening, tiromental distance, mallampati neck movements, prognathia and body weight are used as predictors. Videolaryngoscopes make it possible to image anatomical structures clearly and to carry out laryngoscopy without bringing oral cavity, pharynx and larynx planes to the same level and to perform endotracheal intubation. In children with temporomandibular joint ankylosis, videolaryngoscope is a safe method in providing airway with nasotracheal intubation. Keywords: Temporomandibular joint (TME) ankylosis, mandible, videolaryngoscope, difficult intubation
Authors and Affiliations
Ozkan Onal, Serdal Bozdogan, Emine Cepni Kutahya, Seza Apiliogulları, Omer Erdur
Keywords
Related Articles
- EP ID EP376904
- DOI -
- Views 87
- Downloads 0
Pregnancy tumor: A case report
Abstract: A Pyogenic Granuloma (PG) is a benign growth in the oral cavity that develops from gingiva. Its occurrence during pregnancy is rare. When occurs during pregnancy it is called as granuloma gravidarum or pregnanc...
A Case of Gastric Emphysema Accidentally Found By Computed Tomography for the Evaluation of Trauma
Abstract:The patient was a 55-year-old man who had fallen from a height of 1.5 m when cutting a tree branch. He complained of face, chest, back, right femur and leg pain. He had hypertension and gastritis. He was diagno...
Carcinoma of Penis: A Rare Occurence
Penile cancer has been rarely encountered in our practice and if it is diagnosed late, it may have devastating consequences. We report one such case of squamous cell carcinoma of penile shaft which was diagnosed and tre...
Small cell carcinoma of Lung metastasis to skin –A case report
A 40 year-old male, known case of small cell carcinoma lung presented with multiple painless,cutaneous nodules in the lumbar area of 2 months duration. Fine needle aspiration was doneand revealed metastatic deposits of...
A Rare Intra-Abdominal Rhabdomyosarcoma in a Child (Case Report and Review of Literature)
Rhabdomyosarcoma is the most common soft tissue sarcoma in infants and children. Commonly, it arises from the head and neck, genitor-urinary system, trunk and extremities. Rhabdomyosarcoma arising in the mesentery is ext...