Unravelling Anaesthetic Challenges in Neonate with Cavernous Haemangioma: A Case Report
Haemangiomas are developmental vascular abnormalities characterised by hyperplasia of blood vessels, usually veins and capillaries. Haemangiomas show a higher prevalence in females. More than 50% of lesions are found in the head and neck region, with a particular preponderance over the face, lips, b...
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JCDR Research and Publications Pvt. Ltd.
2024-10-01
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| Series: | Indian Journal of Neonatal Medicine and Research |
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| Online Access: | https://www.ijnmr.net/articles/PDF/2428/73793_CE[Ra1]_F(SHU)_QC(AN_IS)_Ref_Pat(OM)_PF1(AP_OM)_PFA_NC(SHU)_PN(SHU).pdf |
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| author | Monika Madhu Urmi Malik Neha Sahil Shiva |
| author_facet | Monika Madhu Urmi Malik Neha Sahil Shiva |
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| description | Haemangiomas are developmental vascular abnormalities characterised by hyperplasia of blood vessels, usually veins and capillaries. Haemangiomas show a higher prevalence in females. More than 50% of lesions are found in the head and neck region, with a particular preponderance over the face, lips, buccal mucosa, tongue, palate, and trunk. The aetiology can be neoplastic or reactive, influenced by factors such as hormones, infections, and trauma. Large lingual vascular malformations may present with obstructive symptoms, including difficulty in breathing, chewing, swallowing, and speech, which can lead to delays in linguistic development and compromised airway function. Haemangiomas are more susceptible to trauma, which can result in bleeding and further compromise the airway. Typically, this kind of presentation is managed conservatively until obstructive symptoms arise, at which point surgical removal or local site steroid instillation is considered. Here, a case of a 28-day-old child with a cavernous haemangioma of the tongue who was scheduled for excision and instillation of Kenacort injection at the base of the tongue has been reported. Due to the child’s small age and the presence of a lingual mass, the use of intravenous anaesthetic agents was precluded. In this case, because of the non-availability of a paediatric fibreoptic bronchoscope, blind nasal intubation was considered for securing the airway. Managing a compromised airway is a challenging situation, even for an experienced anaesthesiologist, in a routine operating room set-up. However, maintaining spontaneous ventilation is a crucial element during general anaesthesia. |
| format | Article |
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| issn | 2277-8527 2455-6890 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | JCDR Research and Publications Pvt. Ltd. |
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| series | Indian Journal of Neonatal Medicine and Research |
| spelling | doaj-art-7b4035f45c7a4547bca8b0da0a6c7fb92025-08-20T01:57:59ZengJCDR Research and Publications Pvt. Ltd.Indian Journal of Neonatal Medicine and Research2277-85272455-68902024-10-011204010310.7860/IJNMR/2024/73793.2428Unravelling Anaesthetic Challenges in Neonate with Cavernous Haemangioma: A Case ReportMonika0Madhu1Urmi Malik2Neha3Sahil Shiva4Senior Resident, Department of Anaesthesiology, Pt. Bhagwat Dayal Sharma PGIMS, Rohtak, Haryana, India.Senior Resident, Department of Anaesthesiology, Pt. Bhagwat Dayal Sharma PGIMS, Rohtak, Haryana, India.Junior Resident, Department of Anaesthesiology, Pt. Bhagwat Dayal Sharma PGIMS, Rohtak, Haryana, India.Junior Resident, Department of Anaesthesiology, Pt. Bhagwat Dayal Sharma PGIMS, Rohtak, Haryana, India.Junior Resident, Department of Anaesthesiology, Pt. Bhagwat Dayal Sharma PGIMS, Rohtak, Haryana, India.Haemangiomas are developmental vascular abnormalities characterised by hyperplasia of blood vessels, usually veins and capillaries. Haemangiomas show a higher prevalence in females. More than 50% of lesions are found in the head and neck region, with a particular preponderance over the face, lips, buccal mucosa, tongue, palate, and trunk. The aetiology can be neoplastic or reactive, influenced by factors such as hormones, infections, and trauma. Large lingual vascular malformations may present with obstructive symptoms, including difficulty in breathing, chewing, swallowing, and speech, which can lead to delays in linguistic development and compromised airway function. Haemangiomas are more susceptible to trauma, which can result in bleeding and further compromise the airway. Typically, this kind of presentation is managed conservatively until obstructive symptoms arise, at which point surgical removal or local site steroid instillation is considered. Here, a case of a 28-day-old child with a cavernous haemangioma of the tongue who was scheduled for excision and instillation of Kenacort injection at the base of the tongue has been reported. Due to the child’s small age and the presence of a lingual mass, the use of intravenous anaesthetic agents was precluded. In this case, because of the non-availability of a paediatric fibreoptic bronchoscope, blind nasal intubation was considered for securing the airway. Managing a compromised airway is a challenging situation, even for an experienced anaesthesiologist, in a routine operating room set-up. However, maintaining spontaneous ventilation is a crucial element during general anaesthesia.https://www.ijnmr.net/articles/PDF/2428/73793_CE[Ra1]_F(SHU)_QC(AN_IS)_Ref_Pat(OM)_PF1(AP_OM)_PFA_NC(SHU)_PN(SHU).pdfbleedingcorticosteroiddifficult airwaynasotracheal intubation |
| spellingShingle | Monika Madhu Urmi Malik Neha Sahil Shiva Unravelling Anaesthetic Challenges in Neonate with Cavernous Haemangioma: A Case Report Indian Journal of Neonatal Medicine and Research bleeding corticosteroid difficult airway nasotracheal intubation |
| title | Unravelling Anaesthetic Challenges in Neonate with Cavernous Haemangioma: A Case Report |
| title_full | Unravelling Anaesthetic Challenges in Neonate with Cavernous Haemangioma: A Case Report |
| title_fullStr | Unravelling Anaesthetic Challenges in Neonate with Cavernous Haemangioma: A Case Report |
| title_full_unstemmed | Unravelling Anaesthetic Challenges in Neonate with Cavernous Haemangioma: A Case Report |
| title_short | Unravelling Anaesthetic Challenges in Neonate with Cavernous Haemangioma: A Case Report |
| title_sort | unravelling anaesthetic challenges in neonate with cavernous haemangioma a case report |
| topic | bleeding corticosteroid difficult airway nasotracheal intubation |
| url | https://www.ijnmr.net/articles/PDF/2428/73793_CE[Ra1]_F(SHU)_QC(AN_IS)_Ref_Pat(OM)_PF1(AP_OM)_PFA_NC(SHU)_PN(SHU).pdf |
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