Use of video-laryngoscopy in pediatric patients with Ehlers-Danlos syndrome: Two case reports

Abstract

Difficult airway management is one of the most challenging situations for an anesthesiologist. If not handled properly, it can lead to severe complications, even death. Video-laryngoscopy (VL) is one of the many techniques developed for this purpose. Ehlers-Danlos Syndrome (EDS) is a rare disease requiring possible difficult airway management due to temporo-mandibular dysfunction or occipito-atlanto-axial instability. We herein present two pediatric EDS cases who required surgery. The first case was a 9-year-old, male, ASA II EDS patient scheduled for strabismus surgery, and the second case was a 12-year-old, male, ASA III EDS patient who was also diagnosed with a brain cyst and lymphoma, due for emergency surgery for acute abdomen. With their heads in a neutral position, both patients were intubated without tissue trauma at first attempt using video-laryngoscopy. No complications were encountered in both cases. We believe that using video-laryngoscopy for managing difficult pediatric airways may be beneficial in avoiding complications.

Keywords

• Ehlers-Danlos,Anesthesia,Difficult airway,Video-laryngoscopy

Ehlers-Danlos sendromu tanılı iki pediatrik hastada videolaringoskop kullanımı: İki olgu sunumu

Abstract

Zor hava yolu yönetimi, anestezist için en problemli durumlardan biridir ve komplikasyonlara, hatta ölüme neden olabilir. Videolaringoskop, bu sebeple geliştirilen tekniklerden birisidir. Ehlers-Danlos Sendromu, temporomandibular disfonksiyon veya oksipito-atlanto-aksiyel instabilite nedeniyle zor hava yolu yönetimine ihtiyaç duyulabilen nadir bir hastalıktır. Burada Ehlers-Danlos Sendromu (EDS) tanılı iki olgu sunulmuştur. İlk olgu, 12 yaşında, ASA II, EDS tanılı, strabismus nedeniyle cerrahi planlanan erkek hasta, ikinci olgu ise 9 yaşında, ASA III, EDS, beyin kisti ve lenfoma tanılı, akut batın sebebiyle acil cerrahiye ihtiyacı doğan erkek hastadır. Her iki hasta, başları nötral pozisyondayken, dokuyu travmatize etmeden, video-laringoskop ile ilk denemede entübe edilmiştir ve herhangi bir komplikasyonla karşılaşılmamıştır. Olası komplikasyonlardan kaçınmak için pediatrik zor hava yolu yönetiminde video-laringoskop kullanımının faydalı olacağını düşünüyoruz.

Keywords

• Ehlers-Danlos,Anestezi,Zor hava yolu,Videolaringoskop

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