Goldenhar's syndrome: an analysis of anaesthetic management A retrospective study of seventeen cases

Abstract

Summary Seventeen patients with Goldenhar's syndrome who had surgery 28 times are presented. Various authors have reported problems in the anaesthetic management of these patients, but we encountered significant difficulties in only one. Three anaesthetic techniques were used. A thorough pre‐operative assessment with back‐up facilities for difficult intubation are important. Additional cardiorespiratory and craniovertebral anomalies may necessitate modifications in the basic techniques.

Goldenhar Syndrome: A Perpetual Airway Challenge for the Anaesthesiologist

“…Difficult intubation in Goldenhar syndrome arises from a combination of asymmetrical mandibular hypoplasia, hemifacial microsomia, tracheal deviation to one side, and craniovertebral abnormalities [1,2]. In our patient previous attempt at intubation had been successful with Mcintosh blade but this time it revealed a Cormack-Lehane Grade IV.…”

“…Difficult mask ventilation as well as difficult intubation has been reported in patients with Goldenhar syndrome attributed to craniovertebral anomalies, micrognathia, retrognathia and high arched palate which tend to progress with age [1,2]. Various techniques have been used in securing a definitive airway in this paediatric population ranging from tracheostomy in earlier era to fibreoptic bronchoscopy, till date.…”

Airway Management With Direct Laryngoscopy in a Child With Goldenhar Syndrome

“…Gooden et al report on a 21-month-old child with Goldenhar syndrome where nasal and oral FOB intubation was not successful and blind intubation under direct laryngoscopy was performed successfully 7 . In one study, intubation of all 17 children with Goldenhar syndrome who required surgery proved uneventful 8 . According to the technique of anesthesia, standard approach to a child with anticipated difficult airway is inhalation induction with sevoflurane, which ensures adequate depth of anesthesia before airway instrumentation and spontaneous ventilation.…”

Successful tracheal intubation using fiberoptic bronchoscope via an I-gel™ supraglottic airway in a pediatric patient with Goldenhar syndrome -A case report-

“…In particular, difficult ventilation and airway are expected due to hemifacial microsomia, microgenia, mandibular hypoplasia, and vertebral anomalies. Thus, patients with Goldenhar syndrome require careful airway management [1,2]. …”