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Use of the Microcuff® During General Anesthesia for Patients With Scoliosis
Toshiyuki KishimotoDDS, PhD,
Shintaro HayashiDDS,
Yasunori NakanishiDDS,
Takashi GotoDDS, PhD,
Kensuke KosugiDDS, PhD, and
Satoru SakuraiDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 67: Issue 1
Online Publication Date: Jan 01, 2020
DOI: 10.2344/anpr-66-03-01
Page Range: 23 – 27

Scoliosis is characterized by the lateral curvature of the spine in the coronal or frontal plane greater than 10°, as measured by the Cobb angle, that is often accompanied by variable rotation of the vertebrae. 1 , 2 Underlying causes of scoliosis can be classified as congenital, neuromuscular, or idiopathic, which is the most common. The clinical relevance and severity of this condition are related to several factors, including the degree of spinal curvature, with Cobb angles exceeding 40° being considered severe. Furthermore, patients

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Figure 1 ; (A) Perioperative chest radiographs. (B) Chest radiographs after tracheal intubation with a pediatric Microcuff® ETT (Halyard® Microcuff® Pediatric Endotracheal Tube, Oral/Nasal Magill, I.D. 6.0 mm, Halyard Healthcare Inc, Atlanta, Ga), with fixation in the right nostril at 21 cm. The red line indicates the level of the carina. Preoperative chest radiographs (A) showed pronounced scoliosis with a Cobb angle of 50°.
Toshiyuki Kishimoto,
Shintaro Hayashi,
Yasunori Nakanishi,
Takashi Goto,
Kensuke Kosugi, and
Satoru Sakurai
<bold>Figure 1</bold>
Figure 1

(A) Perioperative chest radiographs. (B) Chest radiographs after tracheal intubation with a pediatric Microcuff® ETT (Halyard® Microcuff® Pediatric Endotracheal Tube, Oral/Nasal Magill, I.D. 6.0 mm, Halyard Healthcare Inc, Atlanta, Ga), with fixation in the right nostril at 21 cm. The red line indicates the level of the carina. Preoperative chest radiographs (A) showed pronounced scoliosis with a Cobb angle of 50°.

Figure.; Preoperative anterior-posterior (AP) chest radiograph. AP chest radiograph illustrating severe scoliosis (Cobb angle ∼55°).
Nobuhito Kamekura,
Takayuki Hojo,
Yukie Nitta,
Yuri Hase, and
Toshiaki Fujisawa
Figure.
Figure.

Preoperative anterior-posterior (AP) chest radiograph. AP chest radiograph illustrating severe scoliosis (Cobb angle ∼55°).

Figure 1.; Clinical Picture and Chest Radiograph of the Patient. A, Side view of the patient. B, AP chest radiograph demonstrating significant scoliosis and tracheal deviation.
Toru Yamamoto,
Yuhei Koyama,
Yutaka Tanaka, and
Kenji Seo
Figure 1.
Figure 1.

Clinical Picture and Chest Radiograph of the Patient.

A, Side view of the patient. B, AP chest radiograph demonstrating significant scoliosis and tracheal deviation.

Figure 2 ; Comparison of the distal ends of the tracheal tubes (cuff inflated to 20 cm H2O): (A) Microcuff® ETT (Halyard® Microcuff® Pediatric Endotracheal Tube, Oral/Nasal Magill, I.D. 6.0 mm, Halyard Healthcare Inc, Atlanta, Ga); (B) Portex® ETT (Portex® Oral/Nasal Ivory, I.D. 6.0 mm, Smiths Medical, Keene, NH) I.D. 6.0 mm; (C) Portex® ETT, I.D. 5.5 mm. DM indicates length from the distal edge of the intubation guide/depth mark to distal end of the ETT; DC, length from the distal edge of cuff to the distal end of the ETT; C, length from the distal edge of cuff and proximal edge of cuff; PM, length from the distal edge of intubation guide/depth mark and the proximal edge of cuff; I.D., internal diameter.
Toshiyuki Kishimoto,
Shintaro Hayashi,
Yasunori Nakanishi,
Takashi Goto,
Kensuke Kosugi, and
Satoru Sakurai
<bold>Figure 2</bold>
Figure 2

Comparison of the distal ends of the tracheal tubes (cuff inflated to 20 cm H2O): (A) Microcuff® ETT (Halyard® Microcuff® Pediatric Endotracheal Tube, Oral/Nasal Magill, I.D. 6.0 mm, Halyard Healthcare Inc, Atlanta, Ga); (B) Portex® ETT (Portex® Oral/Nasal Ivory, I.D. 6.0 mm, Smiths Medical, Keene, NH) I.D. 6.0 mm; (C) Portex® ETT, I.D. 5.5 mm. DM indicates length from the distal edge of the intubation guide/depth mark to distal end of the ETT; DC, length from the distal edge of cuff to the distal end of the ETT; C, length from the distal edge of cuff and proximal edge of cuff; PM, length from the distal edge of intubation guide/depth mark and the proximal edge of cuff; I.D., internal diameter.

Anesthetic Management of a Rett Syndrome Patient at High Risk for Respiratory Complications
Nobuhito KamekuraDDS, PhD,
Takayuki HojoDDS, PhD,
Yukie NittaDDS, PhD,
Yuri HaseDDS, PhD, and
Toshiaki FujisawaDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 68: Issue 3
Online Publication Date: Oct 04, 2021
DOI: 10.2344/anpr-68-02-07
Page Range: 163 – 167

, abnormal respiratory control, autonomic dysfunction, various sensitivities to both sedative drugs and volatile anesthetics, airway difficulty, and gastroesophageal reflux. We herein report a case in which intubated general anesthesia was performed 3 times for a patient with RTT who had several risk factors for developing postoperative respiratory complications. These factors primarily included a history of being bedridden, severe scoliosis, and an inability to perform postural changes or sputum expectoration by herself. CASE REPORT The

Cardiac Failure in a Trisomy 9 Patient Undergoing Anesthesia: A Case Report
Cara J. RileyDMD, MS,
Timothy MooreCRNA, MS, MSNA,
Lauren Eagelston,
Dale BurkettMD,
Scott AuerbachMD, and
Richard J. IngMBBCh, FCA(SA)
Article Category: Case Report
Volume/Issue: Volume 64: Issue 1
Online Publication Date: Jan 01, 2017
DOI: 10.2344/anpr-63-04-01
Page Range: 29 – 32

and patient assent, we report a case of undiagnosed cardiomyopathy in a trisomy 9 mosaic patient that was elucidated during a general anesthetic. CASE PRESENTATION A 27-year-old mosaic trisomy 9 female presented for a 2.5-hour dental rehabilitation with extractions under general anesthesia. Physically, she exhibited a bulbous nose, low-set ears, and microcephaly. Her past medical history was significant for premature birth (as a twin born at 34 weeks' gestation), developmental delay, scoliosis, and GER. On the morning of surgery, she

Positional Change Used to Manage Postextubation Respiratory Failure in a Child With Cerebral Palsy
Jun HirokawaDDS, PhD,
Kouichi HidakaDDS,
Mitsuyo KanemaruDH,
Takashi HitosugiDDS, PhD,
Yu OshimaDDS, PhD, and
Takeshi YokoyamaDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 70: Issue 3
Online Publication Date: Oct 18, 2023
DOI: 10.2344/anpr-70-02-08
Page Range: 124 – 127

hypertonia triggered by excessive straining while defecating that resulted in respiratory failure and cardiac arrest. She was successfully resuscitated by mask ventilation and chest compressions. Thereafter, botulinum therapy was started once every 4 months, after which the patient was free of further acute muscle hypertonic attacks. Routine preoperative blood tests and a resting 12-lead electrocardiogram revealed no abnormalities. Preoperative chest radiographs showed no abnormalities except for mild scoliosis. During the preoperative physical examination, her

Repeated Anesthetic Management for a Patient With Klippel-Feil Syndrome
Yuri HasePhD,
Nobuhito KamekuraPhD,
Toshiaki FujisawaPhD, and
Kazuaki FukushimaPhD
Article Category: Other
Volume/Issue: Volume 61: Issue 3
Online Publication Date: Jan 01, 2014
DOI: 10.2344/0003-3006-61.3.103
Page Range: 103 – 106

common form of the disease including our patient, most often have an autosomal dominant inheritance pattern. 1 , 5 KFS can be associated with a number of other anomalies, including renal dysfunction (64%), scoliosis (60%), deafness (30%), Sprengel's scapula deformity (25–35%), congenital heart disease (4.2–14%), mental deficiency, pulmonary disability, and cleft lip and palate. 6 – 10 KFS is a malformation sequence that starts as early as the fourth or beginning of the fifth week of fetal life. 11 KFS encompasses an increasing constellation of clinical

Repeated General Anesthesia in a Patient With Noonan Syndrome
Yoshinao AsahiDDS, PhD,
Ryosuke FujiiDDS, PhD,
Naoko UsuiDDS,
Hajime KagamiuchiDDS, PhD,
Shiro OmichiDDS, PhD, and
Junichiro KotaniDDS, PhD
Article Category: Other
Volume/Issue: Volume 62: Issue 2
Online Publication Date: Jan 01, 2015
DOI: 10.2344/0003-3006-62.1.71
Page Range: 71 – 73

informed that he had been diagnosed with NS in a general hospital near their residence when he was 1 year old. He underwent medical care for pulmonary valve stenosis, scoliosis, bone fragility, epilepsy, and intellectual impairment at the general hospital along with the prescribed follow-up. In March 2011, an oral surgeon at the hospital extracted his third molars under general anesthesia. Although he had received dental treatment in a dental office near his residence in his early childhood under physical restraint, he began to refuse dental treatment as he got older