Adjustable Horseshoe Headrest as a Positioning Adjunct in Airway Management for a Giant Occipital Encephalocele

Reazaul Karim, Habib Muhammad; Yunus, Muhammad; Barman, Angkita; Kakati, Sonai Datta; Dey, Samarjit

Adjustable Horseshoe Headrest as a Positioning Adjunct in Airway Management for a Giant Occipital Encephalocele

Habib Muhammad Reazaul Karim^{1, *}, Muhammad Yunus², Angkita Barman², Sonai Datta Kakati², Samarjit Dey²

¹ Andaman and Nicobar Islands Institute of Medical Sciences & GB Pant Hospital, Port Blair and NEIGRIHMS, Shillong, India

² North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, India

Article Information

Identifiers and Pagination:

Year: 2017
Volume: 11
First Page: 83
Last Page: 87
Publisher ID: TOATJ-11-83
DOI: 10.2174/1874321801711010083

Article History:

Received Date: 31/01/2017
Revision Received Date: 13/03/2017
Acceptance Date: 08/06/2017
Electronic publication date: 29/08/2017
Collection year: 2017

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© 2017 Reazaul Karim et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

^* Address correspondence to this author at the Andaman and Nicobar Islands Institute of Medical Sciences & GB Pant Hospital, Port Blair and NEIGRIHMS, Shillong, India; Tel: +919531847117; E-mail: drhabibkarim@gmail.com

Background:

Presence of a giant occipital encephalocele poses a challenge for laryngoscopy by hindering optimal positioning. Intubations in different positions, assistance and modification of table surfaces have been reported with different rates of success and complications in such cases.

Method:

We used an adjustable horseshoe headrest as a positioning adjunct in airway management in a few cases during 2015 – 2016. Four babies were positioned with the help of the horseshoe headrest for direct laryngoscopy. These cases were then compared with previously conducted one more case whose trachea was intubated by the child’s head beyond the edge after an unsuccessful attempt in lateral position.

Result:

All four cases positioned with adjustable horseshoe head rest were intubated successfully with mean 2 ± 0.81 attempts with 2.25 ± 0.5 Cormack-Lehane laryngeal view. Significant complications were absent in the cases intubated by placing the head in horseshoe headrest as compared to the case performed in lateral position followed by placing the child’s head beyond the edge of the table with assistants supporting the baby.

Conclusion:

This clinical paper discusses this infrequently reported modification, and also compares it with other positions and modifications commonly used in clinical practice.

Keywords: Airway, Laryngoscopy, Horseshoe headrest, Occipital encephalocele, Pediatric anesthesia, Cormack-lehane laryngeal views.

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CASE REPORT

Adjustable Horseshoe Headrest as a Positioning Adjunct in Airway Management for a Giant Occipital Encephalocele

Article Information

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Abstract

Background:

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Result:

Conclusion:

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About the Journal

The Open Anesthesia Journal

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