Management of a difficult airway in a child with Goldenhar syndrome
a case report
DOI:
https://doi.org/10.63162/v67n70e26708Keywords:
Goldenhar syndrome, General anesthesia, Airway management, Brain neoplasms, balanced anesthesiaAbstract
Goldenhar syndrome (GS) is part of the oculoauriculovertebral spectrum (OAVS) characterized by the classic triad of ocular, auricular, and vertebral abnormalities. A 6-month-old, 8.5 kg patient with GS underwent general anesthesia for removal of a cerebral teratoma. Pre-anesthetic evaluation revealed retrognathia, asymmetrical hard palate, and facial asymmetry. Anesthetic induction was by inhalation with 8% sevoflurane combined with 10 mcg of fentanyl, 30 mg of intravenous propofol, and 1.5 mg of cisatracurium. Three attempts at orotracheal intubation were made, the first two via direct laryngoscopy, without glottic visualization, and the third using a videolaryngoscope. In the literature, few cases of successful airway management in GS using a Magill blade, blind intubation, and laryngeal mask airway have been mentioned. Thus, the objective of this article is to report on the management of a difficult airway in a patient with SG.
References
Cohen MM Jr, Rollick BR, Kaye CI. Oculoauriculovertebral spectrum: an updated critique. Cleft Palate J. 1989;26(4):276-86.
Bogusiak K, Puch A, Arkuszewski P. Goldenhar syndrome: current perspectives. World J Pediatr. 2017 Oct;13(5):405-415. doi: 10.1007/s12519-017-0048-z.
Szabo-Rogers HL, Smithers LE, Yakob W, Liu KJ. New directions in craniofacial morphogenesis. Dev Biol. 2010 May 1;341(1):84-94. doi: 10.1016/j.ydbio.2009.11.021.
Touliatou V, Fryssira H, Mavrou A, Kanavakis E, Kitsiou-Tzeli S. Clinical manifestations in 17 Greek patients with Goldenhar syndrome. Genet Couns. 2006;17(3):359-70.
Ahmed Z, Alalami A, Haupert M, Rajan S, Durgham N, Zestos MM. Airway management for rigid bronchoscopy via a freshly performed tracheostomy in a child with Goldenhar syndrome. J Clin Anesth. 2012 May;24(3):234-7. doi: 10.1016/j.jclinane.2011.09.003..
Guerrero-Domínguez R, López-Herrera-Rodríguez D, Benítez-Linero I, Ontanilla A. Anesthetic management for surgery of esophageal atresia in a newborn with Goldenhar syndrome. Rev Bras Anestesiol. 2015;65(4):298-301. doi:10.1016/j.bjane.2013.07.011
Nargozian C, Ririe DG, Bennun RD, Mulliken JB. Hemifacial microsomia: anatomical prediction of difficult intubation. Paediatr Anaesth. 1999;9(5):393-8. doi: 10.1046/j.1460-9592.1999.00374.x
Kajal S, Mukherjee S, Saxena A, Asthana U. Airway management in a patient with Goldenhar syndrome. Sri Lankan J Anaesthesiol. 2017;25(1):44-6. doi:10.4038/slja.v25i1.8179.
Orphan Anesthesia. Goldenhar syndrome: anaesthesia recommendations for patients suffering from rare diseases [Internet]. Munich: OrphanAnesthesia; 2023 [cited 2026 Mar 2]. Available from: https://www.orphananesthesia.eu/rare-diseases/published-guidelines/goldenhar-syndrome/1647-goldenhar-syndrome-2/file.html. DOI: 10.19224/ai2023.S027
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Goiana Journal of Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.
