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Difficult intubation and postoperative aspiration pneumonia associated with Moebius syndrome: a case report

BACKGROUND: Moebius syndrome is a rare congenital disorder characterized by non-progressive palsy of the abducens (VI) and facial (VII) cranial nerves. Its common features include dysfunctions associated with other cranial nerves, orofacial abnormalities, skeletal muscle hypotonia, and other systemi...

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Autores principales: Oda, Aya, Oue, Kana, Oda, Yuki, Taguchi, Shima, Takahashi, Tamayo, Mukai, Akari, Doi, Mitsuru, Shimizu, Yoshitaka, Irifune, Masahiro, Yoshida, Mitsuhiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9552434/
https://www.ncbi.nlm.nih.gov/pubmed/36221060
http://dx.doi.org/10.1186/s12871-022-01859-3
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author Oda, Aya
Oue, Kana
Oda, Yuki
Taguchi, Shima
Takahashi, Tamayo
Mukai, Akari
Doi, Mitsuru
Shimizu, Yoshitaka
Irifune, Masahiro
Yoshida, Mitsuhiro
author_facet Oda, Aya
Oue, Kana
Oda, Yuki
Taguchi, Shima
Takahashi, Tamayo
Mukai, Akari
Doi, Mitsuru
Shimizu, Yoshitaka
Irifune, Masahiro
Yoshida, Mitsuhiro
author_sort Oda, Aya
collection PubMed
description BACKGROUND: Moebius syndrome is a rare congenital disorder characterized by non-progressive palsy of the abducens (VI) and facial (VII) cranial nerves. Its common features include dysfunctions associated with other cranial nerves, orofacial abnormalities, skeletal muscle hypotonia, and other systemic disorders of differing severities. There are several concerns in the perioperative management of patients with Moebius syndrome. CASE PRESENTATION: We present a report on the management of general anesthesia of a 14-year-old male patient with Moebius syndrome who was scheduled for mandibular cystectomy. The patient was diagnosed with Moebius syndrome at the age of 7 years based on his clinical manifestations of nerve palsy since birth and cranial nerve palsy of the trigeminal (V), facial (VII), glossopharyngeal (IX), vagus (X), and sublingual nerves (XII). The patient’s oral morphological abnormalities made intubation difficult. He also experienced dysphagia and aspiration pneumonia on a daily basis. Oral secretions were frequently suctioned postoperatively. However, after discharge, the patient developed aspiration pneumonia and was readmitted to the hospital. CONCLUSIONS: The main problem arising when administering general anesthesia to patients with this syndrome is difficult airway management. The oral abnormalities in these patients, such as small jaw and extreme dental stenosis, make mask ventilation and intubation difficult. Furthermore, this syndrome often involves respiratory impairment and dysphagia due to cerebral nerve palsy, so there is a high risk of postoperative respiratory complications. Since multiple organs are affected in patients with Moebius syndrome, appropriate perioperative management strategies must be prepared for these patients.
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spelling pubmed-95524342022-10-12 Difficult intubation and postoperative aspiration pneumonia associated with Moebius syndrome: a case report Oda, Aya Oue, Kana Oda, Yuki Taguchi, Shima Takahashi, Tamayo Mukai, Akari Doi, Mitsuru Shimizu, Yoshitaka Irifune, Masahiro Yoshida, Mitsuhiro BMC Anesthesiol Case Report BACKGROUND: Moebius syndrome is a rare congenital disorder characterized by non-progressive palsy of the abducens (VI) and facial (VII) cranial nerves. Its common features include dysfunctions associated with other cranial nerves, orofacial abnormalities, skeletal muscle hypotonia, and other systemic disorders of differing severities. There are several concerns in the perioperative management of patients with Moebius syndrome. CASE PRESENTATION: We present a report on the management of general anesthesia of a 14-year-old male patient with Moebius syndrome who was scheduled for mandibular cystectomy. The patient was diagnosed with Moebius syndrome at the age of 7 years based on his clinical manifestations of nerve palsy since birth and cranial nerve palsy of the trigeminal (V), facial (VII), glossopharyngeal (IX), vagus (X), and sublingual nerves (XII). The patient’s oral morphological abnormalities made intubation difficult. He also experienced dysphagia and aspiration pneumonia on a daily basis. Oral secretions were frequently suctioned postoperatively. However, after discharge, the patient developed aspiration pneumonia and was readmitted to the hospital. CONCLUSIONS: The main problem arising when administering general anesthesia to patients with this syndrome is difficult airway management. The oral abnormalities in these patients, such as small jaw and extreme dental stenosis, make mask ventilation and intubation difficult. Furthermore, this syndrome often involves respiratory impairment and dysphagia due to cerebral nerve palsy, so there is a high risk of postoperative respiratory complications. Since multiple organs are affected in patients with Moebius syndrome, appropriate perioperative management strategies must be prepared for these patients. BioMed Central 2022-10-11 /pmc/articles/PMC9552434/ /pubmed/36221060 http://dx.doi.org/10.1186/s12871-022-01859-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Oda, Aya
Oue, Kana
Oda, Yuki
Taguchi, Shima
Takahashi, Tamayo
Mukai, Akari
Doi, Mitsuru
Shimizu, Yoshitaka
Irifune, Masahiro
Yoshida, Mitsuhiro
Difficult intubation and postoperative aspiration pneumonia associated with Moebius syndrome: a case report
title Difficult intubation and postoperative aspiration pneumonia associated with Moebius syndrome: a case report
title_full Difficult intubation and postoperative aspiration pneumonia associated with Moebius syndrome: a case report
title_fullStr Difficult intubation and postoperative aspiration pneumonia associated with Moebius syndrome: a case report
title_full_unstemmed Difficult intubation and postoperative aspiration pneumonia associated with Moebius syndrome: a case report
title_short Difficult intubation and postoperative aspiration pneumonia associated with Moebius syndrome: a case report
title_sort difficult intubation and postoperative aspiration pneumonia associated with moebius syndrome: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9552434/
https://www.ncbi.nlm.nih.gov/pubmed/36221060
http://dx.doi.org/10.1186/s12871-022-01859-3
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