目的:探讨Tr eacher-col l i ns综合征眼睑畸形的治疗方法。方法:应用上睑重睑线切口,形成上睑眼轮匝肌蒂皮瓣,转移修复下睑缺损,同时行外眦复位。结果:2007～2010年间笔者共治疗了3例患者,术后恢复良好,皮瓣均完全成活,随访半年,取得...目的:探讨Tr eacher-col l i ns综合征眼睑畸形的治疗方法。方法:应用上睑重睑线切口,形成上睑眼轮匝肌蒂皮瓣,转移修复下睑缺损,同时行外眦复位。结果:2007～2010年间笔者共治疗了3例患者,术后恢复良好,皮瓣均完全成活,随访半年,取得了满意的效果。结论:应用上睑眼轮匝肌蒂皮瓣修复Treacher-col l i ns综合征眼睑畸形,可Ⅰ期完成下睑缺损和外眦移位的修复,手术方法简单可靠,可获得满意的长期效果。展开更多
Treacher Collins syndrome is caused by the maldevelopment of the first and second branchial arches. It is characterized by mandibulofacial dysostosis and has the following features: outward and downward obliquity of l...Treacher Collins syndrome is caused by the maldevelopment of the first and second branchial arches. It is characterized by mandibulofacial dysostosis and has the following features: outward and downward obliquity of lateral canthi, colobomas of the lateral 1/3 of. the lower eyelids, flattening of malar bone, absence of zygomatic arches, a small and receding chin, sometimes accomapanied with small ears and cleft palate. In 8 cases, the authors reconstructed malar hypoplasia and micrognathia with bone graft and corrected the palpebral fissures. The results of this procedure are satisfactory.展开更多
Patients with Treacher Collins Syndrome (TCS) present unique airway management problems for anesthesiologists due to mandibular micrognathia, the small oral aperture, and temporomandibular joint anomalies. We describe...Patients with Treacher Collins Syndrome (TCS) present unique airway management problems for anesthesiologists due to mandibular micrognathia, the small oral aperture, and temporomandibular joint anomalies. We describe the case of a pediatric TCS patient with limited mouth opening who experienced severe airway obstruction during deep inhalation anesthesia (sevoflurane following i.v. midazolam) for routine dental work. When difficult airway management is expected, intubation of conscious patients is a well-recognized technique in adults;however, it is rarely appropriate for pediatric patients who usually do not cooperate. According to general anesthesia algorithms for pediatric patients with difficult airways, in most pediatric patients, tracheal intubation is performed after the induction of general anesthesia and some authors have reported the usefulness of LMA for maintaining airway patency in patients with TCS. However, in our case LMA could not be used because of severe limitation of mouth opening. In addition, the LMA is so bulky that it is impossible to insert a LMA into patients with narrow airway anatomy. We initially planned to carry out fiber-optic intubation while awake and under sedation if the airway patency could not be secured after the induction of anesthesia. The patient was sedated properly with midazolam and sevoflurane, and awake fiberoptic intubation was performed uneventfully. Our experience in this case highlighted that careful planning of backup contingencies is important in achieving fiberoptic intubation and maintaining airway patency in pediatric TCS patients with limited mouth opening, and that awake intubation can be successful even in pediatric patients.展开更多
文摘目的:探讨Tr eacher-col l i ns综合征眼睑畸形的治疗方法。方法:应用上睑重睑线切口,形成上睑眼轮匝肌蒂皮瓣,转移修复下睑缺损,同时行外眦复位。结果:2007～2010年间笔者共治疗了3例患者,术后恢复良好,皮瓣均完全成活,随访半年,取得了满意的效果。结论:应用上睑眼轮匝肌蒂皮瓣修复Treacher-col l i ns综合征眼睑畸形,可Ⅰ期完成下睑缺损和外眦移位的修复,手术方法简单可靠,可获得满意的长期效果。
文摘Treacher Collins syndrome is caused by the maldevelopment of the first and second branchial arches. It is characterized by mandibulofacial dysostosis and has the following features: outward and downward obliquity of lateral canthi, colobomas of the lateral 1/3 of. the lower eyelids, flattening of malar bone, absence of zygomatic arches, a small and receding chin, sometimes accomapanied with small ears and cleft palate. In 8 cases, the authors reconstructed malar hypoplasia and micrognathia with bone graft and corrected the palpebral fissures. The results of this procedure are satisfactory.
文摘Patients with Treacher Collins Syndrome (TCS) present unique airway management problems for anesthesiologists due to mandibular micrognathia, the small oral aperture, and temporomandibular joint anomalies. We describe the case of a pediatric TCS patient with limited mouth opening who experienced severe airway obstruction during deep inhalation anesthesia (sevoflurane following i.v. midazolam) for routine dental work. When difficult airway management is expected, intubation of conscious patients is a well-recognized technique in adults;however, it is rarely appropriate for pediatric patients who usually do not cooperate. According to general anesthesia algorithms for pediatric patients with difficult airways, in most pediatric patients, tracheal intubation is performed after the induction of general anesthesia and some authors have reported the usefulness of LMA for maintaining airway patency in patients with TCS. However, in our case LMA could not be used because of severe limitation of mouth opening. In addition, the LMA is so bulky that it is impossible to insert a LMA into patients with narrow airway anatomy. We initially planned to carry out fiber-optic intubation while awake and under sedation if the airway patency could not be secured after the induction of anesthesia. The patient was sedated properly with midazolam and sevoflurane, and awake fiberoptic intubation was performed uneventfully. Our experience in this case highlighted that careful planning of backup contingencies is important in achieving fiberoptic intubation and maintaining airway patency in pediatric TCS patients with limited mouth opening, and that awake intubation can be successful even in pediatric patients.
