RT Book, Section
A1 Soder, Christian M.
A2 Hung, Orlando
A2 Murphy, Michael F.
SR Print(0)
ID 55872128
T1 Chapter 46. Airway Management in a 1-Year-Old with Pierre Robin Syndrome for Myringotomy and Tubes
T2 Management of the Difficult and Failed Airway, 2e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-162344-5
LK accessanesthesiology.mhmedical.com/content.aspx?aid=55872128
RD 2024/04/20
AB A  1-year-old-infant  known  to  have  Robin  sequence  (synonym:  Pierre  Robin  syndrome  or  Pierre  Robin  sequence)  presents  with  chronic  otitis  media  and  significant  conductive  hearing  loss.  The  pediatric  otolaryngologist  has  booked  him  for  bilateral  myringotomy  and  tube  insertion.  An  operating  room  time  of  20  minutes  has  been  scheduled.  The  patient  has  been  evaluated  in  the  outpatient  clinic  by  an  anesthesia  colleague.  Her  consultation  report  states  that  the  infant  was  hospitalized  for  the  first  3  months  of  his  life  for  severe  airway  obstruction  and  feeding  difficulties.  Mandibular  distraction  osteogenesis  surgery  is  not  performed  at  this  center,  so  the  airway  was  managed  by  glossopexy  (tongue  sutured  to  lip)  during  the  first  month  of  life.  The  anesthesia  record  for  this  procedure  indicates  that  the  infant  was  intubated  awake  with  great  difficulty  by  a  team  of  pediatric  anesthesia  practitioners,  employing  an  unorthodox  combination  of  the  infant-size  Trachlight™  and  direct  straight-blade  laryngoscopy.  It  is  noted  that  the  infant  currently  still  sleeps  on  his  stomach  without  apparent  apnea  or  airway  obstruction,  but  develops  stridor  and  apnea  if  placed  on  his  back.