141 Treacher collins syndrome – retrospective review of airway management techniques

Abstract

Introduction Treacher Collins Syndrome is a rare disorder of craniofacial development characterised by maxillary, zygomatic, and mandibular dysplasia.1 Anaesthesia in patients with Treacher Collins Syndrome is a challenge, in view of difficult mask ventilation and difficult intubation. Aim To review different airway management techniques in children with Treacher Collins Syndrome. To determine the difficulty of intubation with increasing age. Methods A retrospective review of airway management in children with Treacher Collins Syndrome reported in the difficult airway database from 2010 to 2017. There were 435 difficult airway cases reported, out of these, 26 cases were Treacher Collins Syndrome. The information collected included age, predicted difficult airway, intubation technique, ease of bag mask ventilation, grade of intubation, time taken for intubation and number of attempts. Results There were 26 cases of Treacher Collins Syndrome reported in the difficult airway database during the period 2010 to 2017. Out of these, 50% were difficult bag mask ventilation. We specifically looked into different intubation techniques used. Fibreoptic intubation was used in 8 (30.7%) cases, Airtraq used in 9 (34.6%), GlideScope in 4 (15.38%), fibreoptic intubation via LMA and GlideScope was used in 2 (7.69%) cases each. Discussion and conclusion All the children we analysed had undergone previous anaesthetics with documented previous difficult intubation. Specialised intubation techniques were the preferred option for airway management in these children. We found it difficult to conclude whether the difficulty of intubation increases with age. We acknowledge that our study was very limited. To get more accurate data, we are conducting a prospective study. Reference 1. Hosking J1, Zoanetti D, Carlyle A, et al. Anesthesia for treacher collins syndrome: A review of airway management in 240 pediatric cases. Paediatr Anaesth 2012 August;22(8):752–8. doi:10.1111/j.1460–9592.2012.03829.x [Epub 2012 Mar 7].