Apert syndrome is an autosomal dominant disease associated with several craniofacial and limb deformities. Craniofacial deformities is a challenge in Apert syndrome patients requiring surgery. This is related to airway management during anesthesia. In this report, the authors report a 21-year-old male patient with Apert syndrome who had a mandibular fracture and planned maxillofacial reconstruction. Apert syndrome in this patient was seen from clinical criteria, including syndactyly in both hands and feet, flat forehead, deeper temporal area, shallow orbit with protruding eyes, and long distance between the two eyeballs. This patient had no comorbidities such as hypertension and diabetes mellitus. From the anesthesia department, ASA III and GANET awake plans with FOI were determined. The risk of airway obstruction leading to difficult intubation is overcome by the use of fiber optic during intubation. Another challenge for patients with Apert syndrome is intravenous access. Limb deformities and some surgical procedures make intravenous access more difficult. As a result, some anesthesiologists feel that for short procedures, intravenous access is not mandatory. In an emergency, intraosseous or intramuscular access may be an alternative.
Key words: Apert syndrome, maxillofacial reconstruction, airway management
|
