Airway management of patients with craniofacial abnormalities: 10-year experience at a teaching hospital in Taiwan.

BACKGROUND: Airway management for patients with craniofacial abnormalities poses many challenges. It potentially has a high rate of morbidity and even mortality.

METHODS: We reviewed our experience in administering anesthesia to patients with a diagnosis of mucopolysaccharidosis or Pierre Robin sequence in the past 10 years (July 1998 to October 2008). The anesthetic procedures, methods of airway management, and events of morbidity and mortality were evaluated.

RESULTS: Thirty patients with mucopolysaccharidosis and 53 patients with Pierre Robin sequence were placed under general anesthesia. Although the anesthesiologists always encountered difficulties in managing the airway, most of the anesthetic procedures were performed safely except for 1 case that resulted in mortality.

CONCLUSION: Managing the airway of patients with craniofacial abnormalities can potentially be difficult. It should be carried out by experienced anesthesiologists, with assistance from an otolaryngologist when necessary. A variety of different airway devices should be available if needed.