Intubation of a neonate with glossopalatine ankylosis using a paraglossal approach and a laryngoscope with a straight blade

Anaesthetic management of an infant with cleft palate lateral synechiae syndrome

“…Ty et al reported the case of a 1-day-old neonate with breathing difficulty intubated by blind nasally for synechiae release using cautery 9. Mukharjeea et al report a case of a 7-day-old neonate with glossopalatine ankylosis, who was intubated using a paraglossal approach, using straight blade laryngoscope blade 10…”

Ankyloglossia Superior Syndrome With Complex Craniofacial Anomalies: Case Report and Literature Review

“…With regard to pediatric anesthetic management, especially for ankyloglossia superior, direct laryngoscopy through endotracheal intubation is challenging and controversial. Some authors have reported successful direct oral intubation (Gima et al, 1987) or oral intubation by a paraglossal approach (Mukharjee et al, 2014), and others have used blind nasal intubation (Minami et al, 1995) or nasal intubation with flexible pediatric bronchoscopes to navigate a severely restricted airway (Bolling et al, 2007). In our patient, the fibrous tissue band was relatively thick and firmly attached to the primary palate just behind the middle portion, which rendered direct use of the laryngoscope difficult, and we finally decided to perform nasal intubation under endoscopic visualization.…”

“…Gender Age at operation Limb anomalies Cleft palate/defect Micrognathia Microglossia Anesthesia Spivack and Bennett (1968 Lekkas and Bruaset (1983) Male 14 days À þ À À Local Chicarilli and Polayes (1985) Male Gima et al (1987) Female 5 months, 13 days þ À þ þ General Minami et al (1995) Female 45 days Kothari and Gupta (2005) Male Not reported À À À À Not reported Bolling et al (2007) Female 25 days þ À À À General Mukharjee et al (2014) Female Not reported þ þ À À General Wieker and Sieg (2014) Male 5 years þ þ À À Local Shay and West (2016) Female 0 days þ À À À Local Freire et al (2020) Female Several studies have demonstrated that signaling triggered by transforming growth factor-b3 (TGF-b3) plays a critical role in palatal epithelial fusion (Lane et al, 2014). Mutations in human TGF-b3 have been linked to the cleft palate (Lidral et al, 1998).…”