Simple solution for difficult face mask ventilation in children with orofacial clefts

Area of Science:

• Anesthesiology
• Craniofacial Surgery
• Pediatric Medicine

Background:

• Facial clefts, such as Tessier 3 anomalies, can cause significant air leaks, complicating mask ventilation.
• Existing methods for managing difficult mask ventilation in children, including sterile gauze and laryngeal mask airways, have limitations, especially with uncooperative patients.

Observation:

• A child with a bilateral Tessier 3 anomaly presented with a challenging facial defect predisposing to air leaks.
• Standard ventilation techniques were deemed insufficient for this patient's complex anatomy.

Findings:

• Dental impression material was molded to the facial contour, creating a seal over the cleft.
• This custom-fitted seal facilitated effective ventilation using an appropriately sized face mask.

Implications:

• This technique offers a readily available, adaptable, and effective solution for managing airway challenges in pediatric patients with facial clefts.
• It provides a valuable alternative for improving mask ventilation success in complex craniofacial cases.
• Further research could explore broader applications in pediatric anesthesia and reconstructive surgery.