Management of a difficult airway in a child with partial trisomy 1 mosaic using the pediatric bonfils fiberscope.

摘要

Partial trisomy 1 is a rare chromosomal disorder. Facial dysmorphies with micro-retrognathia seem to be a common feature in these patients. Because these children may need multiple surgical interventions, special attention is required concerning a difficult airway. Our literature search (Pubmed, Medline) did not reveal any article focusing on the airway concerns for anesthetizing these children.The pediatric bonfils, Bonfils Retromolar Intubation Fiberscope? consists of a metal stylet with a fixed anterior tip curvature of 40° containing a fiberoptic bundle and an adjustable eyepiece. It is available in two versions with a diameter of 2 and 3.5 mm. The smaller version can accommodate endotracheal tubes as small as 2.5 mm ID. The adult version of the bonfils rigid fiberscope (OD 5 mm) proved to be a reliable and an atraumatic device by a retromolar approach for the difficult airway (1), whereas the pediatric version was reported to have significant drawbacks when used for intubation of the normal pediatric airway (2). Our own experience documents that these supposed drawbacks disappear simply by additional use of a conventional laryngoscope.