Cystic hygroma: A difficult airway and its anaesthetic implications

Area of Science:

• Pediatric Surgery
• Head and Neck Surgery
• Congenital Abnormalities

Background:

• Cystic hygromas are benign congenital tumors that can cause significant local mass effects.
• Large cystic hygromas in infants can present with feeding difficulties and airway compromise.
• Surgical excision is often indicated for functional improvement and to enable proper growth.

Purpose of the Study:

• To describe the surgical management of a large cystic hygroma in a 2-month-old infant.
• To highlight the anesthetic considerations and postoperative care for such cases.
• To emphasize the importance of anticipating airway difficulties in infants with massive neck swellings.

Main Methods:

• A 2-month-old infant with a large left-sided neck swelling underwent surgical excision.
• Inhalation induction was used for intubation due to anticipated difficult airway.
• Complete tumor excision was performed, followed by postoperative mechanical ventilation.

Main Results:

• The cystic hygroma was successfully and completely excised.
• The intraoperative period was uneventful.
• Postoperative airway difficulties necessitated mechanical ventilation.

Conclusions:

• Surgical excision of large cystic hygromas is feasible and can improve infant outcomes.
• Careful preoperative assessment and anesthetic planning are crucial for managing potential airway issues.
• Postoperative monitoring and respiratory support are essential for infants with significant airway compromise due to neck masses.