Abstract
Syngnathia, congenital fusion of the mandible and maxilla, is a rare anomaly. We describe fiberoptic intubation of the trachea whilst controlling the airway with a nasal tube. A simple modification of this technique, previously described in the management of the difficult pediatric airway [1], simplifies the procedure with less potential for complications.
Highlights
Reported airway management in case of surgery for syngnathia varies from observation or sedation only, up to full control of the airway via various techniques [2,3,4]
An elegant way of providing CPAP/ PEEP whilst simultaneously handling a difficult airway with a fiberoptic bronchoscope (FOB) via one nostril was described by HolmKnudsen et al by inserting an endotracheal tube (3.0 3.5) as a nasopharyngeal airway approximately 8 cm into the contralateral nostril attached to an anesthetic circuit [1]
In managing the difficult pediatric airway either with or without FOB we suggest, in contrast to the original
Summary
Reported airway management in case of surgery for syngnathia varies from observation or sedation only, up to full control of the airway via various techniques [2,3,4]. One of those described is with the aid of a fiberoptic bronchoscope (FOB). By introducing a rather larger sized ETT into the vestibulum nasi only, as illustrated by this case report, this technique becomes easier to perform, with less potential for laryngospasm and/or nasal bleeding (Figure 1)
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