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Treacher Collins 증후군 환아의 기관 삽관 시 마우스가드의 활용

Usefulness of Mouth Guard when the Endotracheal Intubation Is Indicated for Treacher Collins Syndrome Patient

  • 최해인 (연세대학교 치과대학 소아치과학교실) ;
  • 최병재 (연세대학교 치과대학 소아치과학교실) ;
  • 최형준 (연세대학교 치과대학 소아치과학교실) ;
  • 송제선 (연세대학교 치과대학 소아치과학교실) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실)
  • Choi, Haein (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Choi, Byungjai (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Choi, Hyungjun (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Song, Jeseon (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Jaeho (Department of Pediatric Dentistry, College of Dentistry, Yonsei University)
  • 투고 : 2013.08.14
  • 심사 : 2013.11.07
  • 발행 : 2014.02.28

초록

Treacher collins 증후군(TCS)는 25,000명에서 50,000명당 1명의 빈도로 발생하는 상염색체우성의 유전질환이다. 상, 하악의 발육 부전, 부정교합, 양측성 이개 기형, 안검렬의 반몽고증 사면, 구순구개열, 외이도 폐쇄, 중이와 내이의 기형으로 인한 청각 소실등의 구강악안면 부위의 특징을 보여 태생 이후 성인기에 이르기까지 여러 차례에 걸친 외과적 수술을 거치게 된다. 하악골의 형성저하로 하악골이 짧고 후방 위치되며 후방 위치하는 혀와 후비공의 협착과 폐쇄로 인해 상기도가 좁아지게 되는데 이로 인해 기관삽관의 어려움이 따른다. 따라서 치근 발육이 미약한 소아청소년 시기의 TCS 환자의 기관 삽관 시 상악 전치부의 손상 가능성이 매우 높다. 본 증례는 전신마취 유도를 위한 기관 삽관 도중 상악 전치의 완전 탈구가 발생한 TCS 환아의 치험례를 통해 기도 삽관 시사전의 마우스가드 제작의 유용성에 대하여 알리고자 한다.

Treacher Collins syndrome (TCS) is autosomal dominant disorder that occurs approximately 1 in 25,000 to 50,000 live births. The main signs of syndrome are hypoplasia of facial bone and microtia. One in third of them is associated with cleft palate and often shows dental hypoplasia. TCS patients need several number of surgery with general anesthesia throughout their life time for recovery of function and esthetic. Endotracheal intubation of TCS patient is very difficult due to microstomia, retrognathia, choanal stenosis, and decreased oropharyngeal airway. Therefore, general anesthesia of adolescent TCS patient with immature incisor roots has high risk of causing dental trauma. This case is regarding TCS patient who was referred to the Department of Pediatric Dentistry, Yonsei University for avulsed upper left central incisor during endotracheal intubation. The purpose of this report is to emphasize the usefulness of mouth guard to prevent dental trauma when endotracheal intubation is needed for TCS patient.

키워드

참고문헌

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