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Intractable Rare Dis Res. 2019 Nov;8(4):286-288. doi: 10.5582/irdr.2019.01072.

Successful anaesthesia management of a child with hunter syndrome for adenotonsillectomy.

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Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India.
Department of ENT, All India Institute of Medical Sciences, New Delhi, India.


Airway management in a child with hunter syndrome is a challenge to the anesthetists. Various methods to achieve this are reported in literature. Here we describe another method in a three year old male child posted for adenotonsillectomy and myringotomy. After check videolaryngoscopy with C Mac blade size 2, vocal cords were not visible even with various monoevres. Thus a larger blade size 3 was used to place it under the epiglottis after which posterior part of vocal cords became visible and bougie guided endotracheal intubation was successful. Thus we recommend that in a child with hunter syndrome if vocal cords are not visible, a larger blade can be utilized to place under the epiglottis to visualize the vocal cords for successful endotracheal intubation.


C Mac blade; Endotracheal intubation; airway; hunter syndrome

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