Conditions Associated with Difficult Airway Flashcards
Conditions associated with macroglossia
Beckwith syndrome
Trisomy 21
Conditions associated with micrognathia/ mandibular hyoplasia
Pierre Robin
Goldenhar
Treacher Collins
Cri du Chat
Conditions associated with cervical spine anomaly
Klippel-Feil
Trisomy 21
Goldenhar
Pierre Robin considerations
Micrognathia/ mandibular hypoplasia
Tongue falls back and downward
Cleft palate
Neonates often require intubation
Treacher Collins considerations
Small mouth
Micrognathia/ mandibular hypoplasia
Nasal airway blocked by tissue (choanal atresia)
Ocular and auricular anomalies
Trisomy 21 considerations
Small mouth
Large tongue
Atlantoaxial instability
Small subglottic diameter (subglottic stenosis)
Klippel- Feil considerations
Congenital fusion of cervical vertebrae = neck rigidity
Goldenhar considerations
Small/ underdeveloped mandible
Cervical spine abnormality
Beckwith syndrome considerations
Large tongue
Cri du Chat considerations
Small underdeveloped mandible
Laryngomalacia
Stridor
Airway risks of cleft lip and palate
Airway obstruction
Difficult laryngoscopy
Difficult mask ventilation
Aspiration
Dingman- Dott retractor can reduce venous drainage and cause tongue engorgement
Non-airway considerations for cleft lip and palate
Failure to thrive
Cleft lip repair usually ~1month of age
Cleft palate repair usually ~ 12 months of age
Airway considerations for Trisomy 21
Small mouth
Large tongue
Narrow palate with high arch
Midface hypoplasia
Atlantoaxial instability (C1 and C2 subluxation)
Subglottic stenosis
OSA
Chronic pulmonary infection
Airway management for Trisomy 21
Avoid neck flexion during laryngoscopy
Preoperative C- spine radiography
Increased risk of postinbation croup = use smaller ETT
Cardiac conditions associated with Trisomy 21
Most common congenital heart disease is ASD (endocardial cushion defect)
Second most common: VSD
Low levels of circulating catecholamines
Bradycardia is common during sevo induction (tx w/ anticholinergic)
