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Risk Factors for a Difficult Airway in Children with Microtia (Congenital Hypoplasia or Aplasia of the Auricle)

Description

Uezono et al evaluated children with congenital microtia for risk factors associated with difficult intubation. These can help identify a child who should have a more extensive examination prior to anesthesia and additional precautions taken. The authors are from Chiba, Japan and Boston Children's Hospital.


 

Patient selection: Children with unilateral or bilateral microtia (hypoplasia of the auricle)

 

Risk factors from the OMENS classification (orbit, mandible, ear, nerve, soft tissue) of hemifacial microsomia (HFM):

(1) asymmetrical size and/or position of orbit

(2) small mandible and/or abnormal ramus or condyle on X-ray

(3) facial nerve weakness

(4) soft tissue deficiency

 

number of risk factors =

= SUM(number of risk factors present)

 

Interpretation:

• minimum number of risk factors (in addition to microtia): 0

• maximum number of risk factors: 4

• Children with bilateral microtia were more likely to have a difficult airway than those with unilateral microtia.

• The difficulty in visualizing the glottis increased with the number of abnormalities present.

 


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Specialty

ICD-10