GLIDESCOPE^® Core^TMで気管挿管に成功した重度睡眠時無呼吸を伴うトリーチャー・コリンズ症候群の1例

抄録

  Treacher-Collins syndrome (TCS) is often associated with mandibular hypoplasia, presenting significant challenges in securing the airway under general anesthesia. This report details a case of tracheal intubation in a patient with TCS using the GLIDESCOPE^® Core^TM, a device that integrates a video-laryngoscope and bronchoscope.

  A 23-year-old female patient with obstructive sleep apnea due to severe micrognathia was scheduled for the extraction of bilateral impacted mandibular third molars under general anesthesia. Preoperative evaluation, including a lateral cranial radiograph, indicated potential difficulties with mask ventilation and tracheal intubation, prompting a plan for awake intubation. Intravenous midazolam and fentanyl were administered, and oral intubation was attempted using a GLIDESCOPE^® video-laryngoscope. However, due to the patient’s narrow oral cavity, it was initially impossible to guide the tracheal tube to the glottis using the GLIDESCOPE^® video-laryngoscope alone. Thus, a bronchoscope was introduced to guide the tube while the tongue was lifted with the video-laryngoscope, enabling successful intubation. In this case, the video-laryngoscope alone was insufficient ; however, the two-person technique using a video-laryngoscope and bronchoscope provided a clear view of the larynx and facilitated airway management.

  As the GLIDESCOPE^® Core^TM allows simultaneous visualization from both devices on a single screen, it enhances the safety and reliability of the procedure. This makes it suitable for tracheal intubation in patients with micrognathia, such as those with TCS.