Gupta Kumkum, Jain Manish, Gupta Prashant K, Rastogi Bhawana.
Goldenhar syndrome: airway and anesthetic management - a case-report.
J Pak Med Students Jan ;1(2):56-9.

A 10-year old female child presented to ophthalmic outpatient department with history of decreased vision and painless swelling of left eye since birth. Clinical examination of left eye revealed an infero-lateral limbal dermoid with normal fundoscopic examination. There were multiple preauricular appendages in front of the left ear. Both ears were normal in all other respects. The X-ray of cervical spine showed fused third to fifth cervical vertebrae with loss of intervertebral disc but clinical examination found no neurological deficits. X-ray of occipital-mental view found hypoplasia of left maxilla with normally appearing mandible. Clinical examination of the airway revealed restricted head and neck movements with Mallampatti class II which reliably predicted difficult laryngoscopy and intubation. The history, clinical examination of vertebral, auricular and ocular regions, and radiological evaluation confirmed her to be a case of Goldenhar syndrome.A difficult airway continues to be a major cause of anesthesia-related morbidity and mortality and fiberoptic intubation of the spontaneously breathing patients is the technique of choice for elective management of a difficult airway. Therefore, fiberoptic intubation under sedation was planned for the surgery. The intraoperative and postoperative period was uneventful. Lack of anesthesia-related and surgical complications encouraged us to present the advantage of fiberoptic intubation under sedation for successful management of predicted difficult airway.

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