Airway Management of an Achondroplastic Dwarf with Hydrocephalus Undergoing Decompression Surgery
Resource
ACTA ANAESTHESIOLOGICA TAIWANICA v.43 n.3 pp.169-172
Journal
ACTA ANAESTHESIOLOGICA TAIWANICA
Journal Volume
v.43
Journal Issue
n.3
Pages
169-172
Date Issued
2005
Date
2005
Author(s)
CHEN, CHIA-WEN
TSOU, MEI-YUNG
TSAI, SHEN-KOU
TSAO, CHENG-MING
Abstract
軟骨發育不全症是造成侏儒病最常見的原因。其神經學的問題為枕骨肥厚引起枕骨大 孔狹窄造成水腦症，及第一頸椎異常造成之脊髓壓迫，而枕骨下頭顱切開術是治療的 方法。我們報告一個三個月大患有軟骨發育不全症的病例，因枕骨大孔狹窄造成水腦 症必須進行枕骨下頭顱切開減壓手術。外科醫師考量到頸椎伸展可能造成脊髓壓迫更 嚴重，於是要求我們使用清醒時氣管插管，並於插管後確認病人第一頸椎下的運動功 能完好。整個手術過程相當平順，病人也於恢復室清醒並順利拔管。我們同時回顧了 有關軟骨發育不全症的討論及麻醉時可能面臨到的相關問題。 The neurological problem of achondroplasia is hydrocephalus which may arise from stenosis of the foramen magnum secondary to occipital hypertrophy. The spine is also affected by abnormalities in the cervical region (odontoid hypoplasia and occipitalization of C1), which can compound the problem of cord compression. We report a rare instance of achondroplasia in a 3-month-old female infant with the risk of spinal cord compression during the manipulation of endotracheal intubation. For fear of that the surgeon inclined awake intubation in order that spinal cord intactness could be confirmed by neurological test on the spot after intubation. Awake oral endotracheal intubation was performed although with some difficulty, yet the motor function at the first cervical spinal level was unmolested as revealed by neurological test after intubation.
Subjects
軟骨發育不全
開顱手術
水腦
氣管內插管
清醒
Achondroplasia