Aspiration pneumonia due to congenital maxillopalcýtomandibular fusion (A case of difficult intubation)

A there years old boy was admitted to our department after an emergency tracheotomy performed at Emergency Unite; because of alteration of his consciousness and cyanosis. At initial examination micrognatia and underdeveloped growth were observed. There was only ~1 mm of mouth opening. 150/min heart rate, 80/50 mmHg arterial blood pressure, tachypnea (40/min) were noted. The arterial blood gas analysis showed hipoxia and hipercapnia. Because of aspiration pneumonia and acute cardiac failure, the patient was ventilated and treated with antibiotherapy, bronchodilatators and digoxin. After 15 days of treatment the patient had an osteotomy because of maxillopalatomandibular fusion and ~1.5 cm mouth opening was obtained. Later, tracheotomy was decanulated. Maxillopalatomandibular fusion is rare anomaly which presents difficult intubation problem. Our case constitues an example of successful intensive care treatment in maxillopalatomandibular fusion anomaly.

Konjenital maksillopalatomandibuler füzyona baðlý aspirasyon pnömonisi (bir güç entübasyon olgusu)

Üç yaþýnda erkek olgu, ani þuur kaybý ve siyanoz ile getirildi¬ði acil ünitesinde trakeostomi açýldýktan sonra kliniðimize ge¬tirildi. Geliþme geriliði ve mikrognatisi olan olgunun ~1 mm aðýz açýklýðý mevcuttu. Kalp atým hýzý 150 vuru dk-l, arteriyel kan basýncý 80/50 mmllg, solunum sayýsý 40 dk-l, arteriyel kan gazý analizinde lýipoksi ve lýiperkarbisi olan olgu, aspi¬rasyon pnömonisi ve akut kalp yetmezliði ön tanýsý ile ventilatör, hronkodilatatör, antibiotik ve dijital tedavisine alýndý. Tedavisinin 15. gününde maksillopalatomandibuler füzyon nedeniyle osteotomi operasyonu uygulanan olguya ~1.5 cm aðýz açýklýðý saðlandý ve daha sonra trakeostomisi kapatýldý. Olgu, komplikasyonsuz bir yoðun bakým desteði ile tedavi edilmiþ nadir bir maksillopalatomandibuler füzyon ve dolayýsýyla güç entübasyon olgusu olmasý nedeniyle sunulmuþtur.