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Canadian Journal of Anesthesia, Vol 38, 1046-1049, Copyright © 1991 by Canadian Anesthesiologists' Society

ARTICLES

Anaesthetic management of Miller's syndrome

GW Stevenson, SC Hall, BS Bauer, FA Vicari and FL Seleny
Children's Memorial Hospital, Department of Anesthesiology, Chicago, Illinois 60614.

Miller's syndrome is a rare congenital disorder with facial features similar to that of Treacher-Collins syndrome. This report details the anaesthetic management of an infant during multiple surgical procedures, beginning with pylormyotomy at one month of age. Airway management was difficult because of severe micrognathia and was accomplished using an awake intubation with a conventional straight blade modified for continuous administration of oxygen ("oxyscope"). Due to recurrent upper airway obstruction and the anticipated need for multiple surgical procedures in the first years of life, a tracheostomy was placed. Because of the multiple airway, orthopaedic, and nutritional difficulties, it is important that a prospective, multidisciplinary approach be used in these patients' care. Consideration should be given to early tracheostomy for airway maintenance.




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Copyright © 1991 by the Canadian Anesthesiologists' Society.