[Analysis of difficult tracheal intubation in patients with first and second brachial arch syndrome]

We experienced 87 anesthetic managements of 26 patients with first and second brachial arch syndrome in the past 20 years. We analyzed retrospectively the occurrence of difficulty in tracheal intubation with these patients. The incidence of difficult intubation was as high as 39.5% of the cases. Furthermore it was quite difficult to place endotracheal tube, especially in younger children undergoing oral procedure. We examined the correlation among classification of mandibular hypoplasia (Pruzansky classification), the fusion of cervical spines and the degrees of difficulty in intubation for 16 patients who had had radiographs of skull, but we found no correlation among them. But in all the 3 patients with the fusion of cervical spines, intubation was difficult. Therefore, we must perform radiographic assessment of the fusion of the cervical spine.