[A child with Klippel-Feil syndrome in whom GlideScope was effective for tracheal intubation]

GlideScope videolaryngoscope (GlideScope, herein-after referred to as "GS", Verathon Medical, Bothell, WA, USA), with a high-resolution camera positioned on a blade, enables operators to confirm the position of the larynx and a tube through clear view, thereby conducting intubation safely in a patient whose neck is difficult to be bent back. As the blade is slim, GS is indicated for use in children whose oral cavity is narrow. We herein report safe and smooth intubation with GS in a child with Klippel-Feil syndrome in whom difficult intubation was predicted.

Management of Klippel-Feil syndrome combined with Turner syndrome: a case report

A 12-year-old female with Klippel-Feil syndrome (KFS) combined with Turner syndrome (TS) and a submucous cleft palate (CP) was presented. The patient reportedly had TS and had received growth hormone (GH) therapy. Because of her skeletal Class III pattern with a steep mandibular plane angle, facial asymmetry, and fused cervical vertebrae, the effects of the GH on her craniofacial complex needed to be considered at the start of orthopedic/orthodontic treatment. To manage submucous CP with severe maxillary deficiency, a rigid external distraction (RED) device was used. The total active treatment time was 34 months including distraction osteogenesis (DO). Treatment improved both her occlusion and facial appearance.

[Clinical and therapeutic approach to Klippel-Feil syndrome in the primary care medicine]

A case of Klippel-Feil syndrome in a female nine years is informed. The patient presented a clinical picture compatible with Klippel-Feil syndrome: short neck with joint movements diminished and low hair implantation. We showed the diagnostics and treatment approach at the primary medicine level, the follow-up until the presence of clinical manifestations of the main clinical problems associated. The liver, cardiovascular, audiology, and muscle-bones are describe and finally some aspects of her physical rehabilitation.

[Audiological evaluation of a child with Klippel-Feil syndrome]

A 6-year-old boy with formerly diagnosed Klippel-Feil syndrome (KFS) presented with complaints of hearing loss, speech disorder, and problems related to his hearing aid. Clinical examination and computed tomography showed bilateral external and middle ear anomalies and audiological examination revealed bilateral severe conductive hearing impairment. The patient was prescribed a bone conduction hearing aid and, with necessary consultations, was examined for additional physical anomalies. All children with a diagnosis of KFS should be evaluated with audiologic and otologic examinations, consultations should be implemented with other disciplines concerning the presenting problems, a regular follow-up should be scheduled, and the parents should be informed on possible complications.

Occipitoatlantoaxial instability and congenital thoracic vertebral deformity in Pierre Robin sequence: a case report

STUDY DESIGN

Case report of a patient with Pierre Robin sequence who presented with occipitoatlantoaxial instability and congenital thoracic deformity.

OBJECTIVE

As there are lack of similar cases in the literature, we would like to introduce a case of a patient with associated malformations, the consultations that we consider that are obligatory, and our decision-making process. We would also like to demonstrate the follow-up plan and the further key points about either the conservative or the surgical solution of the problem.

SUMMARY OF BACKGROUND DATA

The occurrences of 2 malformations (Pierre Robin sequence and occipitoatlantoaxial instability) together are very rare. We have found only 1 publication in the related literature about this topic. We consider that this rare appearance is due to the difficulty in diagnosing this problem. There is no clinical evidence that musculoskeletal examinations are indicated in a patient with Pierre Robin sequence, and it is difficult to check for all the possible deformities.

METHOD

As congenital scoliosis appeared only at 6 years of age in the case of this child with Pierre Robin syndrome, we promptly began to investigate for other musculoskeletal defects. We would like to demonstrate the investigation process and emphasize the necessity of conventional and functional radiographs, computed tomography, and magnetic resonance images.

RESULTS

We have not found similar cases to refer to, so we made our decision about conservative treatment of the craniocervical instability knowing that we will have to follow up the progression of both the congenital thoracic scoliotic deformity and the occipitoatlantoaxial instability later.

CONCLUSION

To recognize a rare case is a big challenge indeed due to the lack of the investigational protocol, the key points of the decision process, the prognostic classification system, and the progression of the disease. We recommend that one should individualize and follow up the patient frequently.

Klippel-Feil syndrome

The triad of short neck, low posterior hairline and severe restriction of cervical motion is a classic definition of Klippel-Feil syndrome. The anatomic and clinical expressions of this syndrome vary widely, ranging from mild cosmetic deformity to severe disability. The diagnosis is usually apparent on lateral cervical radiographs.