Abstract
The perioperative period of airway surgery on children with severe motor and intellectual disabilities (CSMID) is difficult to manage due to the number and severity of their comorbidities. The aim of the present study was to analyze CSMID who underwent airway surgery to clarify which clinical variables might predict the occurrence of problems in airway surgery of CSMID and adequate management to ensure a safe outcome. Medical records at Yamagata University Hospital were retrospectively investigated for CSMID between 2001 and 2012, and 24 CSMID for whom an operation was verified were identified. Details were reviewed including clinical status, category and purpose of surgery, age distribution, and outcome. CSMID under the age of 2 accounted for about 60% of all cases, with infants being the most common. CSMID underwent airway surgery for the purpose of securing the airway in about 50% of cases, while aspiration prevention was the purpose in about 40%. Tracheostomy was involved in 40% of the operations to prevent aspiration. Half of the CSMID underwent an operation to prevent aspiration after the age of 6 because aspiration became more severe as thoracic deformity worsened over time. Because CSMID need careful perioperative management and have the possibility of requiring additional surgery at various ages, we must take appropriate action depending on the situation in collaboration with pediatricians. It is important to promote understanding of the need for appropriate airway surgery within affected families and obtain further details about the need to operate.
