Difficult airway approach in patient with Oro-Facial-Digital syndrome type II or Mohr syndrome: a case report
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Health Residencies Journal (HRJ) |
Texto Completo: | https://escsresidencias.emnuvens.com.br/hrj/article/view/139 |
Resumo: | Oro-facio-digital syndrome is a rare disorder of embryonic development. Patients may have deformities in the mouth, face, hands and feet. At least 11 different clinical forms of the syndrome have been described, including oro-facial-digital syndrome type II or Mohr syndrome. The approach of the airway in the oro-facial-digital syndrome can be a challenge because craniofacial changes such as leborine lip / cleft palate, present in the syndrome, are predictors of difficult airway in pediatrics. The case report describes a 4-month-old infant with Mohr Syndrome who was admitted with respiratory symptoms and during hospitalization presented cardiac arrest, with direct laryngoscopy performed several times, without success in orotracheal intubation. The anatomical differences explain the greater potential for technical difficulties of the airways in infants than in teenagers or adults. In general, the airways of infants differ from those of adults by five points: 1) the relatively large size of the child's tongue, in relation to the oropharynx; 2) the larynx has a more cephalic location on the neck; 3) the epiglottis is short, omega-shaped and angled over the larynx entrance; 4) the vocal cords are angled, consequently, a tracheal tube that has passed blindly can easily lodge in the anterior commissure instead of sliding into the trachea; 5) the larynx is funnel-shaped, with the narrowest portion located in the cricoid cartilage. The guidelines for difficult airways in pediatrics are essential tools in this context for the prevention of associated complications, so their mastery by intensive care professionals and anesthesiologists is essential. Sharing this information is important because there is little data in the literature about approaching the airway in a patient with Mohr syndrome. |
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Difficult airway approach in patient with Oro-Facial-Digital syndrome type II or Mohr syndrome: a case reportAbordagem de via aérea difícil em paciente com Síndrome Orofaciodigital tipo II ou Síndrome de Mohr: um relato de casosíndrome orofaciodigital tipo II; síndrome Mohr; manejo de via aérea; via aérea difícil.oro-facial-digital type II; Mohr syndrome; airway management; difficult airway.Oro-facio-digital syndrome is a rare disorder of embryonic development. Patients may have deformities in the mouth, face, hands and feet. At least 11 different clinical forms of the syndrome have been described, including oro-facial-digital syndrome type II or Mohr syndrome. The approach of the airway in the oro-facial-digital syndrome can be a challenge because craniofacial changes such as leborine lip / cleft palate, present in the syndrome, are predictors of difficult airway in pediatrics. The case report describes a 4-month-old infant with Mohr Syndrome who was admitted with respiratory symptoms and during hospitalization presented cardiac arrest, with direct laryngoscopy performed several times, without success in orotracheal intubation. The anatomical differences explain the greater potential for technical difficulties of the airways in infants than in teenagers or adults. In general, the airways of infants differ from those of adults by five points: 1) the relatively large size of the child's tongue, in relation to the oropharynx; 2) the larynx has a more cephalic location on the neck; 3) the epiglottis is short, omega-shaped and angled over the larynx entrance; 4) the vocal cords are angled, consequently, a tracheal tube that has passed blindly can easily lodge in the anterior commissure instead of sliding into the trachea; 5) the larynx is funnel-shaped, with the narrowest portion located in the cricoid cartilage. The guidelines for difficult airways in pediatrics are essential tools in this context for the prevention of associated complications, so their mastery by intensive care professionals and anesthesiologists is essential. Sharing this information is important because there is little data in the literature about approaching the airway in a patient with Mohr syndrome.A síndrome orofaciodigital é um transtorno raro do desenvolvimento embrionário. Os pacientes podem apresentar alterações de boca, face, mãos e pés. Há descrito pelo menos 11 formas clínicas diferentes da síndrome, entre elas a síndrome orofaciodigital tipo II ou síndrome de Mohr. A abordagem de via aérea na síndrome orofaciodigital pode ser um desafio, já que as alterações craniofaciais como lábio leporino/fenda palatina, presentes na síndrome, são preditores de via aérea difícil em pediatria. O relato de caso descreve uma lactente de 4 meses, portadora de Síndrome de Mohr que foi admitida com sintomas respiratórios e, durante internação, apresentou parada cardiorrespiratória, sendo realizada laringoscopia direta por diversas vezes, sem sucesso na intubação orotraqueal. As diferenças anatômicas explicam o potencial maior de dificuldades técnicas das vias aéreas em lactentes do que em adolescentes ou adultos. Em geral, as vias aéreas dos lactentes diferem das de adultos por cinco pontos: 1) tamanho relativamente grande da língua da criança em relação à orofaringe; 2) a laringe tem localização mais cefálica no pescoço; 3) a epiglote é curta, em forma de ômega e angulada sobre a entrada da laringe; 4) as cordas vocais são anguladas, consequentemente, um tubo traqueal que passou cegamente pode facilmente se alojar na comissura anterior em vez de deslizar para dentro da traqueia; 5) a laringe é em forma de funil, sendo a porção mais estreita localizada na cartilagem cricoide. Os guidelines de via aérea difícil em pediatria são ferramentas essenciais, nesse contexto, para prevenção de complicações associadas sendo assim imprescindível o domínio destes por profissionais intensivistas e anestesiologistas. O compartilhamento dessas informações se torna importante já que há poucos dados na literatura sobre abordagem de via aérea em paciente com Síndrome de Mohr.Escola Superior de Ciências da Saúde2021-04-27info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://escsresidencias.emnuvens.com.br/hrj/article/view/13910.51723/hrj.v2i11.139Health Residencies Journal - HRJ; v. 2 n. 11 (2021): Cuidados Paliativos: desafios e oportunidades; 17-252675-2913reponame:Health Residencies Journal (HRJ)instname:Escola Superior de Ciências da Saúde (ESCS)instacron:ESCSporhttps://escsresidencias.emnuvens.com.br/hrj/article/view/139/146Copyright (c) 2021 Pedro Thiago Hideyuki Takagi, Bruno Zeuxis de Siqueira, Guilherme Peixoto Mendonça, Adriana Navarro Machado, André Santana Pratahttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessHideyuki Takagi, Pedro Thiago Zeuxis de Siqueira, Bruno Peixoto Mendonça, Guilherme Navarro Machado, Adriana Santana Prata, André 2023-03-17T18:08:33Zoai:ojs.emnuvens.com.br:article/139Revistahttps://escsresidencias.emnuvens.com.br/hrjPUBhttps://escsresidencias.emnuvens.com.br/hrj/oaihrj@escs.edu.br || vanessacampos@escs.edu.br2675-29132675-2913opendoar:2023-03-17T18:08:33Health Residencies Journal (HRJ) - Escola Superior de Ciências da Saúde (ESCS)false |
dc.title.none.fl_str_mv |
Difficult airway approach in patient with Oro-Facial-Digital syndrome type II or Mohr syndrome: a case report Abordagem de via aérea difícil em paciente com Síndrome Orofaciodigital tipo II ou Síndrome de Mohr: um relato de caso |
title |
Difficult airway approach in patient with Oro-Facial-Digital syndrome type II or Mohr syndrome: a case report |
spellingShingle |
Difficult airway approach in patient with Oro-Facial-Digital syndrome type II or Mohr syndrome: a case report Hideyuki Takagi, Pedro Thiago síndrome orofaciodigital tipo II; síndrome Mohr; manejo de via aérea; via aérea difícil. oro-facial-digital type II; Mohr syndrome; airway management; difficult airway. |
title_short |
Difficult airway approach in patient with Oro-Facial-Digital syndrome type II or Mohr syndrome: a case report |
title_full |
Difficult airway approach in patient with Oro-Facial-Digital syndrome type II or Mohr syndrome: a case report |
title_fullStr |
Difficult airway approach in patient with Oro-Facial-Digital syndrome type II or Mohr syndrome: a case report |
title_full_unstemmed |
Difficult airway approach in patient with Oro-Facial-Digital syndrome type II or Mohr syndrome: a case report |
title_sort |
Difficult airway approach in patient with Oro-Facial-Digital syndrome type II or Mohr syndrome: a case report |
author |
Hideyuki Takagi, Pedro Thiago |
author_facet |
Hideyuki Takagi, Pedro Thiago Zeuxis de Siqueira, Bruno Peixoto Mendonça, Guilherme Navarro Machado, Adriana Santana Prata, André |
author_role |
author |
author2 |
Zeuxis de Siqueira, Bruno Peixoto Mendonça, Guilherme Navarro Machado, Adriana Santana Prata, André |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Hideyuki Takagi, Pedro Thiago Zeuxis de Siqueira, Bruno Peixoto Mendonça, Guilherme Navarro Machado, Adriana Santana Prata, André |
dc.subject.por.fl_str_mv |
síndrome orofaciodigital tipo II; síndrome Mohr; manejo de via aérea; via aérea difícil. oro-facial-digital type II; Mohr syndrome; airway management; difficult airway. |
topic |
síndrome orofaciodigital tipo II; síndrome Mohr; manejo de via aérea; via aérea difícil. oro-facial-digital type II; Mohr syndrome; airway management; difficult airway. |
description |
Oro-facio-digital syndrome is a rare disorder of embryonic development. Patients may have deformities in the mouth, face, hands and feet. At least 11 different clinical forms of the syndrome have been described, including oro-facial-digital syndrome type II or Mohr syndrome. The approach of the airway in the oro-facial-digital syndrome can be a challenge because craniofacial changes such as leborine lip / cleft palate, present in the syndrome, are predictors of difficult airway in pediatrics. The case report describes a 4-month-old infant with Mohr Syndrome who was admitted with respiratory symptoms and during hospitalization presented cardiac arrest, with direct laryngoscopy performed several times, without success in orotracheal intubation. The anatomical differences explain the greater potential for technical difficulties of the airways in infants than in teenagers or adults. In general, the airways of infants differ from those of adults by five points: 1) the relatively large size of the child's tongue, in relation to the oropharynx; 2) the larynx has a more cephalic location on the neck; 3) the epiglottis is short, omega-shaped and angled over the larynx entrance; 4) the vocal cords are angled, consequently, a tracheal tube that has passed blindly can easily lodge in the anterior commissure instead of sliding into the trachea; 5) the larynx is funnel-shaped, with the narrowest portion located in the cricoid cartilage. The guidelines for difficult airways in pediatrics are essential tools in this context for the prevention of associated complications, so their mastery by intensive care professionals and anesthesiologists is essential. Sharing this information is important because there is little data in the literature about approaching the airway in a patient with Mohr syndrome. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-04-27 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://escsresidencias.emnuvens.com.br/hrj/article/view/139 10.51723/hrj.v2i11.139 |
url |
https://escsresidencias.emnuvens.com.br/hrj/article/view/139 |
identifier_str_mv |
10.51723/hrj.v2i11.139 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://escsresidencias.emnuvens.com.br/hrj/article/view/139/146 |
dc.rights.driver.fl_str_mv |
https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Escola Superior de Ciências da Saúde |
publisher.none.fl_str_mv |
Escola Superior de Ciências da Saúde |
dc.source.none.fl_str_mv |
Health Residencies Journal - HRJ; v. 2 n. 11 (2021): Cuidados Paliativos: desafios e oportunidades; 17-25 2675-2913 reponame:Health Residencies Journal (HRJ) instname:Escola Superior de Ciências da Saúde (ESCS) instacron:ESCS |
instname_str |
Escola Superior de Ciências da Saúde (ESCS) |
instacron_str |
ESCS |
institution |
ESCS |
reponame_str |
Health Residencies Journal (HRJ) |
collection |
Health Residencies Journal (HRJ) |
repository.name.fl_str_mv |
Health Residencies Journal (HRJ) - Escola Superior de Ciências da Saúde (ESCS) |
repository.mail.fl_str_mv |
hrj@escs.edu.br || vanessacampos@escs.edu.br |
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1797051239267041280 |