Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Apert syndrome is a rare congenital disorder characterized by craniosynostosis, midface hypoplasia, and syndactyly, frequently associated with challenging airway management. Craniofacial malformations increase the risk of difficult mask ventilation, intubation, and postoperative airway obstruction. We report the anesthetic management of a 5‐year‐old child with Apert syndrome undergoing cleft palate repair. Anticipating a difficult airway due to craniofacial abnormalities, a comprehensive airway strategy was prepared, including pediatric‐sized video laryngoscope blades, a fiberoptic bronchoscope, supraglottic devices, and surgical airway backup. Inhalational induction with spontaneous ventilation was followed by successful intubation using an endogenously developed 3D‐printed pediatric video laryngoscope with integrated bougie port and a pre‐shaped stylet. A 4.0 mm North Pole RAE tube was secured. Surgery proceeded uneventfully, and the patient was extubated fully awake with no complications. Midface hypoplasia, high‐arched palate, and limited neck extension in Apert syndrome significantly increase airway difficulty. While fiberoptic bronchoscopy remains the gold standard, video laryngoscopy offers enhanced visualization and higher first‐attempt success rates in pediatric difficult airways. In this case, the endogenously developed 3D‐printed pediatric video laryngoscope with integrated bougie port provided a low‐cost, customizable, and sterilizable solution suitable for resource‐limited settings. Maintaining spontaneous ventilation until airway control, awake extubation, and a robust backup plan were critical to preventing complications. In pediatric syndromic patients, innovative, low‐cost airway tools‐such as endogenously developed 3D‐printed pediatric video laryngoscopes with integrated bougie ports‐can improve safety and efficiency. Careful preoperative planning, maintenance of spontaneous ventilation until airway control, and a robust backup strategy are key for optimal outcomes.
How to cite this article:
S. Shanthi and Yachendra . Through the Narrow Passage: Innovative Airway Securing in a Child with Apert Syndrome for Cleft Palate Repair.
DOI: https://doi.org/10.36478/makrjms.2024.10.696.699
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2024.10.696.699