Difficult Laryngoscopy/Intubation: The Child with Mandibular Hypoplasia

1 July 1983

journal article
research article
Published by SAGE Publications in Annals of Otology, Rhinology & Laryngology

Vol. 92 (4) , 401-404
https://doi.org/10.1177/000348948309200423

Abstract

The child with mandibular hypoplasia (Treacher Collins syndrome, Pierre Robin sequence, hemifacial microsomia, etc) presents the otolaryngologist and anesthesiologist with considerable problems when direct laryngoscopy and/or endotracheal intubation is attempted. In addition to the small mandible, several other features of these patients contribute to the difficult laryngoscopy: macroglossia, glossoptosis, trismus related to temporomandibular joint abnormalities, and prominent maxilla or maxillary incisors. Most of the techniques that have been described for laryngoscopy/intubation in problem cases are difficult or impossible to use in infants and young children with mandibular hypoplasia. We present a modification of the standard direct laryngoscopic procedure, utilizing the 9-cm anterior commissure laryngoscope and an optical stylet in the task of exposing and intubating the larynx of a child with mandibular hypoplasia.

Keywords

This publication has 6 references indexed in Scilit:

Difficult Pediatric Endotracheal Intubation
Anesthesiology, 1981
Special Anesthetic Techniques in Head and Neck Surgery
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Treacher Collins syndrome
Anaesthesia, 1963