Preauricular skin tags and difficult tracheal intubation: a case report

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Clinical Genetics

Background:

• Difficult tracheal intubation remains a significant cause of anesthesia-related mortality in children, particularly those with congenital airway anomalies or rare syndromes.
• Preauricular tags, a congenital anomaly, can occur in isolation or be associated with complex syndromes involving craniofacial and nephrourological abnormalities.
• Assessing the airway in pediatric patients with preauricular tags is crucial due to potential associated malformations.

Observation:

• A retrospective analysis of seven pediatric patients (3-18 months) undergoing surgical ablation of preauricular tags was conducted.
• Two patients presented with unexpected or suspected difficult tracheal intubation.
• Both patients with intubation difficulties were native residents of Sri Lanka.

Findings:

• Preauricular tags can be indicative of underlying airway abnormalities that complicate pediatric tracheal intubation.
• A thorough medical history and physical examination are essential for identifying potential difficult airways in children with preauricular tags.
• Limiting intubation attempts and considering alternative airway management strategies are recommended when facing difficult intubations in this population.

Implications:

• Healthcare providers should consider preauricular tags as a potential risk factor for difficult pediatric intubation.
• Early identification and management of airway challenges in children with preauricular tags can improve patient safety during anesthesia.
• Further research is warranted to elucidate the specific association between preauricular tags and airway anomalies in pediatric populations.