Videolaryngoscopy Bails us out of Difficult Intubation Scenarios in Syndromic Children: A Case Series

Abstract

Airway management in children with craniofacial anomalies can be complicated and may require multiple attempts with conventional direct laryngoscopy (DL). Videolaryngoscopes (VLs) have a well-established role in difficult airway management in adults; however, their role remains to be fully elucidated in paediatric age group. There is a relative paucity in the literature regarding the role of VLs in cases of syndromic children, and it is not clear whether they should be used as an initial option or as a rescue device. Herein, we report a series of cases of children with Pierre Robin sequence, Beckwith-Wiedemann syndrome, and Hurler's syndrome wherein VLs proved beneficial after multiple failed DL attempts. Following initial failed attempts to intubate using DL, these children were subsequently intubated using VLs. Therefore, VLs should be used for initial intubation attempts in syndromic children with potential difficult airways.

Keywords: Airway management; child; congenital abnormality; intubation; videolaryngoscopy.

Figure 1

Pierre Robin sequence neonate

Figure 2

Beckwith–Wiedemann syndrome neonate

Figure 3

Beckwith–Wiedemann syndrome neonate being intubated with Truview-PCD VL, and glottic view on the monitor

Figure 4

Hurlers syndrome child with foot deformity (inset)

Figure 5

Hurler’s child (side profile)