High Le Fort I and bilateral split sagittal osteotomy in Crouzon syndrome
| Autor: | Yoong Chuan Tay, Kian Hian Tan, Vincent Yeow |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Narcotics medicine.medical_specialty medicine.medical_treatment Osteotomy Sagittal Split Ramus Blood Loss Surgical Gene mutation Hypotension Controlled Osteotomy Craniosynostosis Remifentanil Piperidines medicine Intubation Intratracheal Humans Osteotomy Le Fort Hypertelorism Airway Management Hypoplastic maxilla Morphine business.industry Orthognathic Surgical Procedures Craniofacial Dysostosis Crouzon syndrome Autosomal dominant trait Analgesia Patient-Controlled General Medicine Perioperative medicine.disease Surgery Airway Obstruction Otorhinolaryngology Atracurium Prognathism medicine.symptom business Anesthetics Intravenous Malocclusion Neuromuscular Nondepolarizing Agents |
| Zdroj: | The Journal of craniofacial surgery. 24(3) |
| ISSN: | 1536-3732 |
| Popis: | Crouzon syndrome is a rare, autosomal dominant disease from a fibroblast growth factor receptor 2 gene mutation, characterized by premature craniosynostosis, hypertelorism, orbital proptosis, psittichorina, hypoplastic maxilla, and mandibular prognathism. We present an adult 32-year-old Crouzon syndrome patient who underwent an elective High Le Fort I and bilateral split sagittal osteotomy for midface advancement with a background of jaw malocclusion and obstructive respiratory symptoms. The operation features a potential dynamic movement of the secured airway in the surgical field and close proximity to exposed ocular structures. Permissive hypotensive anesthesia was employed to improve the surgical field and reduce intraoperative blood loss and dose of long-acting opioids. He was extubated at the end of an uneventful surgery and was monitored in the high dependency overnight before he was discharged to the general ward. Perioperative issues include potential difficult airway management; ocular, auditory, and neurological injury prevention; surgery-specific anesthetic technique; and postoperative analgesia. Understanding the multisystemic issues facilitates the dynamic anesthetic management during surgery. Good communication among the multidisciplinary team is essential to ensure a successful operation and uneventful recovery. |
| Databáze: | OpenAIRE |
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