Treacher Collins syndrome is an inherited disorder resulting in maldevelopment of the first and second branchial arches. Patients have complex orofacial anatomy often requiring airway interventions from birth. A 17-year-old boy with Treacher Collins syndrome and history of difficult ventilation and intubation presented for elective maxillofacial reconstruction. After uneventful awake nasal fiberoptic intubation, the nasotracheal tube was damaged intraoperatively. Due to the patient’s unique anatomy, a fiberoptic bronchoscope and ventilating exchange catheter were utilized together to facilitate a nasotracheal tube exchange. This case demonstrates the utilization of a combination of advanced airway techniques in an urgent perioperative setting.
From the Department of Anesthesiology and Perioperative Medicine, University of Rochester, Rochester, New York.
Accepted for publication December 6, 2018.
The authors declare no conflicts of interest.
Address correspondence to Lynnie R. Correll, MD, PhD, Department of Anesthesiology and Perioperative Medicine, University of Rochester, 601 Elmwood Ave, PO Box 604 Rochester, NY 14642. Address e-mail to firstname.lastname@example.org.