Zor Hava Yoluna Neden Olabilen Pediyatrik Sendromlar

Yıl 2023, Cilt: 6 Sayı: 2, 366 - 374, 31.08.2023

Ebru Biricik

https://doi.org/10.36516/jocass.1071305

Cited By: 1

Öz

Amaç: Pediyatrik yaş grubunda zor hava yoluna sebep olabilecek sendromlar çok daha fazla görülebilmektedir. Bu sendromlara bağlı gerek hava yolu ile ilgili gerekse diğer organ ve sistemlerle ilgili cerrahi geçirmeleri veya hava yolunun açılmasına yönelik girişimler endike olabilmektedir. Bu derlemede pediyatrik sendromların neden zor hava yoluna neden olabilecekleri sunulmaya çalışılmıştır.
Materyal ve Metot: Bu derlemede olgu sunumları, derlemeler ve kitaplarda bulunan literatür bilgileri bir araya getirilmiştir.
Bulgular: Özellikle maksillofasiyal anomaliler ve deposit sendromlara bağlı anatomik bozukluklar zor hava yoluna neden olabilmektedir. Ayrıca bu çocukların büyümesi ile birlikte anatomic anomaliler daha da artmakta ve böylece tekrarlayan cerrahiler geçirmek zorunda kalmaktadırlar. Cerrahi öncesi iyi bir fizik muayene ve görüntüleme yöntemlerinin kullanılması zor hava yolunun öngörülebilmesini sağlayabilir.
Sonuç: Sendromik çocuklardaki anatomic değişiklikler ve geçirilmiş cerrahiler zor hava yolu riskini artırmaktadır. Bu çocukların preoperative değerlendirmesinin multidispliner olması ve görüntüleme yöntemlerinin kullanılması ile birlikte hava yolu yönetimi daha kolay hale getirilebilir.

Anahtar Kelimeler

pediyatrik sendromlar, zor hava yolu, zor entübasyon, maksillofasiyal anomaliler

Kaynakça

• 1. Tobias JD. Pediatricairway anatomy may not be what we thought: implications for clinical practice and the use of cuffed endotracheal tubes. Pediatr Anesth. 2015;25:9-19.
• 2. Hack HA, Walker R, Gardiner P. Anaesthetic implications of the changing management of patients with mucopolysaccharidosis. Anaesth Intensive Care. 2016;44:660-668.
• 3. Geoff Frawley, Daniella Fuenzalida, Susan Donath et al. A retrospective audit of anesthetic techniques and complications in children with mucopolysaccharidoses. Paediatr Anaesth. 2012;22:737-744.
• 4. Kendigelen P, Tunali Y, Tutuncu A et al. Emergency bronchoscopy for foreign-body aspiration in a child with type I mucopolysaccharidosis: a challenging airway management experience. J Anesth. 2016;30:696-698.
• 5. An Approach to the Airway Management in Children with Craniofacial Anomalies DOI: http://dx.doi.org/10.5772/intechopen.93426.
• 6. Drummond JC, Krane EJ, Tomatsu Set al. Paraplegia after epidural-general anesthesia in a Morquio patient with moderate thoracic spinal stenosis. Can J Anesth. 2015;62:45-49.
• 7. Kamin W. Diagnosis and management of respiratory involvement in Hunter syndrome. Acta Paediatr. 2008;97:57-60.
• 8. Aldenhoven M, Wynn RF, Orchard PJ et al. Long-term outcome of Hurler syndrome patients after hematopoietic cell transplantation: an international multicenter study. Blood 2015; 125:2164-2172.
• 9. Kubaski F, de Oliveira Poswar F, Michelin-Tirelli K et al. Mucopolysaccharidosis Type I. Diagnostics (Basel). 2020 Mar 16;10:161. 10. Korayem M, Nuha MA, Waleed B et al. Craniofacial manifestations of Down syndrome: A review of literature. Academia Journal of Scientific Research. 2019;7:176-181.
• 11. Lewanda AF, Matisoff A, Revenis M et al. Preoperative evaluation and comprehensive risk assessment for children with Down syndrome. Paediatr Anaesth. 2016;26:356-362.
• 12. Mitchell RB, Call E, Kelly J. Diagnosis and therapy for airway obstruction in children with Down syndrome. Arch Otolaryngol Head Neck Surg. 2003;129:642-645.
• 13. Boudjenah B, Adham A.M.B, Chinnappa S.M et al. Special Considerations in Human Airway Management. An Approach to the Airway Management in Children with Craniofacial Anomalies. 2020: Chapter 9; 153-176.
• 14. E Rosellen Dedlow, Siraj Siddiqi, Donald J Fillipps et al. Tuli Symptomatic atlantoaxial instability in an adolescent with trisomy 21 (Down's syndrome). Clin Pediatr (Phila). 2013;52:633-638.
• 15. Bertrand P, Navarro H, Caussade S, et al. Airway anomalies in children with Down syndrome: endoscopic findings. Pediatr Pulmonol. 2003;36:137–141.
• 16. De Lausnay M, Verhulst S, Boel L, et al. The prevalence of lower airway anomalies in children with Down syndrome compared to controls. Pediatr Pulmonol. 2020;55:1259–1263.
• 17. Paletta CE, Dehghan K, Hutchinson RL et al. A fall of the base of the tongue considered as a cause of nasopharyngeal respiratory impairment: Pierre Robin sequence, a translation. Plast Recontr Surg. 1994;93:1301–1303.
• 18. Smith JD. Treatment of airway obstruction in Pierre Robin syndrome. A modified lip-tongue adhesion. Arch Otolaryngol. 1981;107:419–421.
• 19. Sesenna E, Magri AS, Magnani C et al. Mandibular distraction in neonates: Indications, techniques, results. Ital J Pediatr. 2012;38:7.
• 20. Pearl W. Congenital heart disease in the Pierre Robin syndrome. Pediatr Cardiol. 1982;2:307–309.
• 21. Cladis F, Kumar A, Grunwaldt L et al. Pierre Robin Sequence: A Perioperative Review. Anesth Analg. 2014;119:400–412.
• 22. Collins E T. Cases with symmetrical congenital notches in the outer part of each lid and defective development of the malar bones. Trans Ophthalmol Soc U K. 1900;20:190–192.
• 23. Trainor PA, Dixon J, Dixon MJ. Treacher Collins syndrome: etiology, pathogenesis and prevention. Eur J Hum Genet. 2009; 17: 275–283.
• 24. Hosking J, Zoanetti D, Carlyle A et al. Anesthesia for Treacher Collins syndrome: a review of airway management in 240 pediatric cases. Pediatric Anesthesia. 2012;22: 752–758.
• 25. Duque C, Lopes Cardoso I. Treacher Collins syndrome and implications in the oral cavity. Clinical Research and Trials. 2019;5:1-5.
• 26. Cohen MM. An etiologic and nosologic overview of craniosynostosis syndromes. Birth Defects. 1975;11:137–189.
• 27. Hohoff A, Joos U, Meyer U et al. The spectrum of Apert syndrome: phenotype, particularities in orthodontic treatment, and characteristics of orthognathic surgery. Head & Face Medicine. 2007;3:10-24.
• 28. Nargozian C. The airway in patients with craniofacial abnormalities. Paediatric Anaesthesia. 2004;14:53-59.
• 29. Mann D, Garcia PJ, Andropoulos DB. Anesthesia for the patient with a genetic syndrome. In: Andropoulos DB, Gregory GA, editors. Gregory’s Pediatric Anesthesia. 6th ed. Wiley- Blackwell;2020.
• 30. Carinci F, Pezzetti F, Locci P, et al. Apert and Crouzon syndromes: clinical findings, genes, and extracellular matrix. Journal of Craniofacial Surgery. 2005;16:361-368.
• 31. Hoeve LJ, Pijpers M, Joosten KF. OSAS in craniofacial syndromes: An unsolved problem. Int J Pediatr Otorhinolaryngol. 2003;67:111–113.
• 32. Forte AJ, Lu X, Hashim PW et al. Airway Analysis in Apert Syndrome. Plast Reconstr Surg. 2019;144:704-709.
• 33. Doerga PN, Spruijt B, Mathijssen IM et al. Upper airway endoscopy to optimize obstructive sleep apnea treatment in Apert and Crouzon syndromes. J Craniomaxillofac Surg. 2016;44:191–196.
• 34. Ganeriwal V, Dey P, Gore B et al. Anesthesia challenges in a case of Crouzon syndrome for corrective rigid external distraction frame insertion. 2019;20:42-45.
• 35. Conrady CD, Patel BC. Crouzon Syndrome. 2021 Aug 11. In: StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK518998/
• 36. Warren SM, Proctor MR, Bartlett SP et al. Parameters of care for craniosynostosis: craniofacial and neurologic surgery perspectives. Plast Reconstr Surg. 2012;129:731-737.
• 37. Friedhoff RJ. Anesthesia for pediatric craniofacial surgery. Finnanest. 2000;33:387.
• 38. Cohen MM. Pfeiffer syndrome update, clinical subtypes, and guidelines for differential diagnosis. Am J Med Genet. 1993;45:300-307.
• 39. Hockstein NG, McDonald-McGinn D, Zackai E et al. Tracheal Anomalies in Pfeiffer Syndrome. Arch Otolaryngol Head Neck Surg. 2004;130:1298-1302.
• 40. Chen LC, Holinger LD. Congenital tracheal anomalies: pathology study using serial macrosections and review of the literature. Pediatr Pathol. 1994;14:513-537.
• 41. Fearon JA, Rhodes J. Pfeiffer Syndrome: A Treatment Evaluation. Plast Reconstr Surg. 2009;123:1560.
• 42. Shinji K, Toshihiko F, Kazunori Y et al. Overcorrected Midface Advancement to Improve Airway Problems in Severe Pfeiffer Syndrome Types II and III. Journal of Craniofacial Surgery. 2019;1:53-56.
• 43. Karaman A, Laloğlu F, Kahveci H. Goldenhar Sendromu: Olgu Sunumu. Bakırköy Tıp Dergisi. 2013;3:131-133.
• 44. Molins G, Valls A, Guijarro R, Hernández-Alfaro F. Mandibular hypoplasia and narrow airway in Goldenhar syndrome: Anticipation of difficult intubation with cone-beam computed tomography. Journal of Clinical Anesthesia. 2016;34:1-2. DOI: 10.1016/j.jclinane.2016.03.031
• 45. Sun YH, Zhu B, Ji BY, Zhang XH. Airway Management in a Child with Goldenhar Syndrome. Chin Med J (Engl). 2017 Dec 5;130(23):2881-2882.
• 46. Graybeal LS, Baum VC, Durieux ME. Anaesthetic management of a patient with tricho-rhino-phalangeal syndrome European Journal of Anaesthesiology. 2005;22:400 – 402.
• 47. Esmaeilzadeh S, D’Souza RS, Stewart TM et al. Urgent Airway Management and Postoperative Complications in a Patient with Trichorhinophalangeal Syndrome. Case Rep Anesthesiol. 2020;2020:8835533.
• 48. Shawky RM, Elkhalek HSA, Elghawaby AES et al. Trichorhinophalangeal syndrome II, expanding the clinical spectrum Egyptian Journal of Medical Human Genetics. 2015;16:89-94.
• 49. Bali Ç, Özmete Ö, Ergenoğlu P et al. Edwards Sendromu'nda Anestezi Yönetimi (Trizomi 18) Turk J Anaesthesiol Reanim. 2016;44:157-158.
• 50. Cereda A, Carey JC. The trisomy 18 syndrome. Orphanet J Rare Dis.2012;7:81.
• 51. Birmingham EE, Stucke AG, Diaz CD. Anesthesia for children with complete trisomy 18 (Edwards syndrome): A cohort review of 84 anesthesia encounters in nine patients. Pediatric Anesthesia. 2021;31:419–428.
• 52. Kettler EB, Bhattacharjee R, Lesser D et al. Sleep disordered breathing in children with trisomy 13 and trisomy 18. Am J Otolaryngol. 2020;41:102555.
• 53. Gruber J, Saleh A, Bakhsh W, et al. The prevalence of Klippel-Feil syndrome: a computed tomography-based analysis of 2,917 patients. Spine Deform. 2018;6(4):448–53.
• 54. Guille JT, Sherk HH. Congenital osseous anomalies of the upper and lower cervical spine in children. J Bone Joint Surg Am. 2002;84:277–288.
• 55. Zhang X, Wang J, Liu Y et al. A rare case of difficult airway management in a Klippel-Feil syndrome pediatric patient with osseous torticollis undergone orthopedic surgery Difficult airway in pediatric patient with torticollis. BMC Anesthesiol. 2021;21:121.
• 56. Tagawa T, Akeda K, Asanuma Y, et al. Upper airway obstruction associated with flexed cervical position after posterior occipitocervical fusion. J Anesth. 2011;25(1):120–2.
• 57. Miyata M, Neo M, Fujibayashi S, et al. O-C2 angle as a predictor of dyspnea and/or dysphagia after occipitocervical fusion. Spine (Phila Pa 1976). 2009; 34:184–188.
• 58. Schnell D, Planquette B, Berger A, et al. Cuff leak test for the diagnosis of post-extubation stridor: a Multicenter evaluation study. J Intensive Care Med. 2019;34:391–396.
• 59. Zaballa MG, Perez-Ferrer A, Charco-Mora P. Difficult airway in a pediatric patient with Klippel-Feil syndrome and an unexpected lingual tonsil. Minerva Anestesiol 2012;78:254-257.
• 60. Menard RM, Delaire J, Schendel SA. Treatment of the craniofacial complications of Beckwith-Wiedemann syndrome. Plast Reconstr Surg. 1995;96:27–33.
• 61. Batra M, Valecha UK. Anesthetic management of tongue reduction in a case of Beckwith-Wiedemann syndrome. J Anaesthesiol Clin Pharmacol. 2014;30:562–564.
• 62. Sequera-Ramos L, Duffy KA, Fiadjoe JE et al. The Prevalence of Difficult Airway in Children with Beckwith-Wiedemann Syndrome: A Retrospective Cohort Study. Anesth Analg. 2021;133:1559-1567.
• 63. Tanrıverdi S, Ayçiçek R, Bağcı O et al. Prenatal Tanılı Omfalosel ve Beckwith-Wiedemann Sendromu: Olgu Sunumu. Perinatoloji Dergisi. 2011;19:140-144.
• 64. Roizin L, Gold G, Berman HH et al. Congenital vascular anomalies and their histopathology in Sturge–Weber–Dimitri syndrome (naevus flammeus with angiomatosis and encephalosis calcificans). J Neuropathol Exp Neurol. 1959;1:75–97.
• 65. Irving ND, Lim JH, Cohen B et al. Sturge– Weber syndrome: ear, nose, and throat issues and neurologic status. Pediatr Neurol. 2010;43:241–244.
• 66. Khanna P, Ray BR, Govindrajan SR et al. Anesthetic management of pediatric patients with Sturge–Weber syndrome: our experience and a review of the literature. J Anesth. 2015;29:857–861.
• 67. Wong HS, Abdul Rahman R, Choo SY et al. Sturge-Weber-Syndrome with extreme ocular manifestation and rare association of upper airway angioma with anticipated difficult airway. Med J Malaysia. 2012;67:435-437.
• 68. Esterly NB, McKusick VA. Stiff skin syndrome. Pediatrics. 1971;47:360-369.
• 69. Kiss EE, Alex G, Chandran N et al. Anesthetic implications of a pediatric patient with stiff skin syndrome: A case report. Pediatric Anesthesia. 2020;30:1149–1152.
• 70. Wang T, Yang Y, Dong Q et al. Acromicric dysplasia with stiff skin syndrome-like severe cutaneous presentation in an 8-year-old boy with a missense FBN1 mutation: Case report and literature review. Mol Genet Genomic Med. 2020;8:1282.