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VOLUME 11 , ISSUE 2-3 ( May-December, 2018 ) > List of Articles

CASE REPORT

Airway Management in Arrhinia: A Case Report and Literature Review

Erika Celis-Aguilar, Sergio Verdiales, Ivonne Leon-Leyva, Roberto Miranda-Maciel

Citation Information : Celis-Aguilar E, Verdiales S, Leon-Leyva I, Miranda-Maciel R. Airway Management in Arrhinia: A Case Report and Literature Review. Clin Rhinol An Int J 2018; 11 (2-3):61-64.

DOI: 10.5005/jp-journals-10013-1345

License: CC BY-NC 4.0

Published Online: 16-12-2020

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Aim: To describe optimal airway management in arrhinia. Background: Arrhinia is the congenital absence of the external nose, nasal cavities, and olfactory bulb, and this congenital anomaly is extremely rare. In newborns with this anomaly, airway management is urgent and crucial. There is no consensus on the airway management of these patients. Case description: A 22-year-old female visited our unit due to blindness and purulent discharge in the right eye of 5 years of evolution. She had arrhinia and was treated with an emergent tracheotomy at birth. Currently, she has purulent lacrimal ducts, leukoma in the right eye, hypertelorism, presence of nasofacial scar, absence of incisors, and neck with tracheocutaneous fistula. She had a previous history of six nasal reconstructive surgeries. She breathed through her mouth and tracheocutaneous fistula. She denied any airway difficulty. Discussion: We described an adult case with arrhinia. She breathed effortlessly through a tracheocutaneous fistula, and as a newborn a tracheotomy was necessary. An airway management consensus in arrhinia has not been described. We describe a thorough literature review on arrhinia and airway management. Conclusion: Arrhinia is a congenital malformation that carries the risk of respiratory difficulty. These patients require a multidisciplinary team to manage the newborn and choosing the appropriate alternative for securing the airway. Treatments described are orotracheal intubation, oropharyngeal tube, nasal reconstruction, and tracheotomy in patients who do not develop oral breathing. Tracheotomy is a definitive treatment in these patients. Clinical significance: There are various treatments for airway management of arrhinia. Clinicians should be aware of these treatment options.


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