Hipertelorizm Nedeniyle Kraniofasiyal Cerrahi Uygulanan Pediatrik Hastada Anestezi Yönetimi
Özet
Ailesi tarafından yüzde şekil bozukluğu şikayeti ile getirildiği beyin cerrahi ve plastik cerrahi klinikleri tarafından değerlendirilen, 5 yaşında, 18 kg ağırlığında, 98 cm boyunda kız çocuk hastada nazal deformite ve orbital hipertelorizm saptanmış, düzeltme amaçlı kraniofasiyal cerrahi planlanmıştı. Yapılan muayenesinde interpupiller mesafesi 68 mm olarak ölçülmüştü. Özgeçmişinde daha önce geçirilmiş yarık damak ve yarık dudak cerrahisi, sık üst solunum yolu enfeksiyonu (ÜSYE) geçirme hikayesi yanında, demir eksikliği anemisi hikayesi mevcuttu. Prematür doğum ya da daha önce yoğun bakım yatış öyküsü bulunmayan hastanın, ek sistemik hastalığı ve devam eden oral demir tedavisi dışında kullandığı ilaç yoktu. Mevcut yüz deformitesi nedeniyle beyin cerrahi ve plastik cerrahi klinikleri tarafından orbitofrontal ilerletme ve eş zamanlı olarak rinoplasti ameliyatı planlanan hasta, preoperatif hazırlık amacıyla anesteziyoloji polikliniğine yönlendirilmişti.
A 5-year-old female patient, weighing 18 kg and with a height of 98 cm, who was brought by her family with a complaint of facial deformity and evaluated by the neurosurgery and plastic surgery clinics, was found to have nasal deformity and orbital hypertelorism; craniofacial surgery was planned for correction. In her physical examination, the interpupillary distance was measured as 68 mm. Her medical history revealed a history of previous cleft palate and cleft lip surgery, frequent upper respiratory tract infections (URTI), as well as iron deficiency anemia. The patient had no history of premature birth or previous intensive care unit admission, and no additional systemic diseases or medication use, except for the ongoing oral iron therapy. The patient, for whom orbitofrontal advancement and concurrent rhinoplasty surgery were planned by the neurosurgery and plastic surgery clinics due to the existing facial deformity, was referred to the anesthesiology outpatient clinic for preoperative preparation.
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