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Difficult airway in a child with severe dystonia

Published online by Cambridge University Press:  25 February 2013

N Eze  and
G A Morrison
N Eze*
Affiliation:
ENT Department, Evelina Children's Hospital, London, UK
G A Morrison
Affiliation:
ENT Department, Evelina Children's Hospital, London, UK
*
Address for correspondence: Dr N Eze, ENT Department, Surgical Offices, North Wing, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK Fax: 020 7188 2192 E-mail: [email protected]
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Abstract

Objective:

To describe the management of a 15-year-old girl with repeated life-threatening complications of her tracheostomy secondary to muscle dystonia and thoracolumbocervical lordosis.

Method:

This paper reports a retrospective case review.

Results:

Regular microlaryngoscopy and bronchoscopy, treatment with systemic steroids and a soft tracheostomy tube, in addition to better control of the dystonia, resulted in control of the patient's airway. This minimised tracheal inflammation and granulation tissue formation.

Conclusion:

The need for a tracheostomy in patients with thoracolumbocervical lordosis and severe dystonia should be considered only after all other options of airway management have been explored. Every attempt should be made to minimise tracheal trauma caused by excessive movement of a tracheostomy tube.

Keywords

TracheostomyChildDystoniaTracheomalaciaGranulation Tissue
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 4 , April 2013 , pp. 438 - 439
Copyright
Copyright © JLO (1984) Limited 2013

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References

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