Percutaneous dilational tracheotomy for airway management in a newborn with Pierre-Robin syndrome and a glossopharyngeal web.

Abstract

Pierre-Robin syndrome (PRS) is often associated with difficulty in endotracheal intubation. We present the use of percutaneous dilational tracheotomy (PDT) for airway management of a newborn with PRS and a glossopharyngeal web. A 2-day-old term newborn with PRS and severe obstructive dyspnea was evaluated by the anesthesiology team for airway management. A direct laryngoscopy revealed a glossopharyngeal web extending from the base of the tongue to the posterior pharyngeal wall. The infant was spontaneously breathing through a 2 mm diameter fistula in the center of this web. It was decided that endotracheal intubation was impossible, and a PDT was planned. The trachea of the newborn was cannulated, using a 20 gauge peripheral venous catheter and a 0.71 mm guide wire was introduced through this catheter. Using 5 French, 7 French, 9 French, and 11 French central venous catheter kit dilators, staged tracheotomy stoma dilation was performed. By inserting a size 3.0 tracheotomy cannula, PDT was successfully completed in this newborn. This case describes the successful use of PDT for emergency airway management of a newborn with PRS and glossopharyngeal web.

• Authors: Arash Pirat, Selim Candan, Aytekin Unlükaplan, Ozgür Kömürcü, Selim Kuşlu, Gülnaz Arslan
• Journal: Respiratory care (Respir Care) Vol. 57 Issue 4 Pg. 627-30 (Apr 2012) ISSN: 0020-1324 [Print] United States
• PMID: 22005668 (Publication Type: Case Reports, Journal Article)

Topics

• Airway Management
• Dilatation
• Dyspnea (complications, therapy)
• Emergency Medical Services
• Female
• Humans
• Infant, Newborn
• Intubation, Intratracheal
• Laryngeal Masks
• Mandible (surgery)
• Osteotomy
• Pharynx (pathology)
• Pierre Robin Syndrome (complications)
• Tongue (pathology)
• Tracheotomy (methods)