Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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Difficult intubation caused by an immature upper airway in a patient with cri-du-chat syndrome: a case report

  • So, Eunsun (Department of Anesthesiology, School of Dentistry, Dankook University) ;
  • Kim, Seungoh (Department of Anesthesiology, School of Dentistry, Dankook University)
  • Received : 2019.02.09
  • Accepted : 2020.02.20
  • Published : 2020.02.28
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Abstract

Cri-du-chat syndrome (CdCS) is caused by the deletion of the short arm of chromosome 5. Most patients with CdCS develop intellectual disabilities. Therefore, they have poor oral hygiene and a high caries index. However, treating such patients is not an easy task, because of the difficulty in communication. General anesthesia may be a useful option in adult patients with CdCS and intellectual disability. General anesthesia should be administered very carefully, owing to the presence of comorbid diseases, which may need airway management. Infants with CdCS need general anesthesia if they have a concomitant cardiac anomaly. Intubation is reportedly difficult for such patients was, owing to the structural and functional abnormalities in the larynx and vocal cords. The purpose of this study was to report a case of difficult intubation while inducing general anesthesia in a patient with CdCS during dental treatment, due to a narrow larynx and trachea.

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References

  1. Niebuhr E. The cri du chat syndrome: Epidemiology, cytogenetics, and clinical features. Hum Genet 1978; 44: 227-75. https://doi.org/10.1007/BF00394291
  2. Overhauser J, Huang X, Gersh M, Wilson W, McMahon J, Bengtsson U, et al. Molecular and phenotypic mapping of the short arm of chromosome 5: Sublocalization of the critical region for the cri-du-chat syndrome. Hum Mol Genet 1994; 3: 247-52. https://doi.org/10.1093/hmg/3.2.247
  3. Mainardi PC, Pastore G, Castronovo C, Godi M, Guala A, Tamiazzo S, et al. The natural history of cri du chat syndrome. A report from the italian register. Eur J Med Genet 2006; 49: 363-83. https://doi.org/10.1016/j.ejmg.2005.12.004
  4. Solanki J, Gupta S, Arya A. Dental caries and periodontal status of mentally handicapped institutilized children. J Clin Diagn Res 2014; 8: ZC25-7.
  5. Lim MAWT, Borromeo GL. The use of general anesthesia to facilitate dental treatment in adult patients with special needs. J Dent Anesth Pain Med 2017; 17: 91-103. https://doi.org/10.17245/jdapm.2017.17.2.91
  6. Haywood PT, Karalliedde LD. General anesthesia for disabled patients in dental practice. Anesth Prog 1998; 45: 134-8.
  7. Lim SW, So E, Yun HJ, Karm MH, Chang J, Lee H, et al. Analysis of the effect of oral midazolam and triazolam premedication before general anesthesia in patients with disabilities with difficulty in cooperation. J Dent Anesth Pain Med 2018; 18: 245-54. https://doi.org/10.17245/jdapm.2018.18.4.245
  8. Park CH, Kim S. Survey of the sevoflurane sedation status in one provincial dental clinic center for the disabled. J Dent Anesth Pain Med 2016; 16: 283-8. https://doi.org/10.17245/jdapm.2016.16.4.283
  9. Bersten AD, Rutten AJ, Vedig AE, Skowronski GA. Additional work of breathing imposed by endotracheal tubes, breathing circuits, and intensive care ventilators. Crit Care Med 1989; 17: 671-7. https://doi.org/10.1097/00003246-198907000-00015
  10. Asai T, Shingu K. Difficulty in advancing a tracheal tube over a fibreoptic bronchoscope: incidence, causes and solutions. Br J Anaesth 2004; 92: 870-81. https://doi.org/10.1093/bja/aeh136
  11. Wang TK, Wu RS, Chen C, Chang TC, Hseih FS, Tan PP. Endotracheal tube size selection guidelines for chinese children: prospective study of 533 cases. J Formos Med Assoc 1997; 96: 325-9.
  12. Inamoto Y, Saitoh E, Okada S, Kagaya H, Shibata S, Baba M, et al. Anatomy of the larynx and pharynx: effects of age, gender and height revealed by multidetector computed tomography. J Oral Rehabil 2015; 42: 670-7. https://doi.org/10.1111/joor.12298
  13. Prakash M, Johnny JC. Whats special in a child's larynx? J Pharm Bioallied Sci 2015; 7: S55-8.
  14. Guala A, Spunton M, Mainardi PC, Emmig U, Acucella G, Danesino C. Anesthesia in cri du chat syndrome: Information on 51 italian patients. Am J Med Genet A 2015; 167A: 1168-70.