HNO-ärztliche Notfälle im Kindesalter

Das Nager–Syndrom. Probleme und Möglichkeiten der Therapie

“…A nasopharyngeal tube will initially enable the child to breath either through the tube itself or through the gap it leaves [6]. In the past a mandibular extension system was often used but is rejected today since the children have restricted freedom of movement over a long period of time.…”

“…In the past a mandibular extension system was often used but is rejected today since the children have restricted freedom of movement over a long period of time. Early veloplasty to keep the tongue out of the cleft is to be considered [6]. Though this method results in restricted tongue mobility and in scar tissue, good results have been reported in avoiding respiratory obstruction resulting from the posterior position of the tongue [1,6,12].…”

“…Long-term intubation or tracheotomy [6] is the last resort with life-threatening respiratory obstructions, which frequently lead to tracheal stenosis in children. More recently positive experiences have been reported with a laryngeal mask, an inflatable mask-like device which is placed in the pharynx immediately above the larynx [4,6].…”

“…Primary velopharyngoplasty is recommended in Nager patients, though problems with oro/nasopharngeal intubation are almost inevitable [3,6,19]. Bronchoscopic intubation is advisable, with the tube being inserted via a thin flexible bronchoscope.…”

“…Der Velumverschluss wird bei diesem Krankheitsbild als primäre Velopharyngoplastik empfohlen, wobei mit Problemen bei der oro-oder auch nasotrachealen Intubation gerechnet werden muss[3,6,19]. Empfehlenswert ist die bronchoskopische Intubation, bei der der Tubus über ein dünnes flexibles Bronchoskop eingeführt wird.…”