Anesthetic Management of a Juvenile Hyaline Fibromatosis Patient With Trismus and Cervical Movement Limitation.

Asako Yasuda, Noriko Miyazawa, Emiko Inoue, Tomoaki Imai, Yoshiki Shionoya, Kiminari Nakamura

Anesthesia progress 2021 Jun 01

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Juvenile hyaline fibromatosis (JHF) is a rare autosomal recessive disease characterized by the presence of tissue nodules, joint contractures, and gingival hyperplasia. With a 1-year-9-month-old female patient scheduled for a gingivectomy and excision of a lower lip mass under general anesthesia, it was anticipated that airway management would be difficult because of trismus and limited cervical movement. Intubation with video-laryngoscopic assistance could not be achieved because gingival hyperplasia and trismus prevented blade insertion and manipulation. Therefore, 2 endotracheal tubes were used: 1 used as a nasopharyngeal airway for assisted ventilation, and 1 used for intubation along with a flexible fiberoptic scope. This case demonstrated a useful method for managing ventilation and intubation in patients with JHF, particularly when the use of oral airway devices is difficult. © 2021 by the American Dental Society of Anesthesiology.

Citation

Asako Yasuda, Noriko Miyazawa, Emiko Inoue, Tomoaki Imai, Yoshiki Shionoya, Kiminari Nakamura. Anesthetic Management of a Juvenile Hyaline Fibromatosis Patient With Trismus and Cervical Movement Limitation. Anesthesia progress. 2021 Jun 01;68(2):117-118