Anesthetic management in a case of Klippel-Feil syndrome and literature review

ABSTRACT

Klippel-Feil syndrome is known by the classic triad of shortness of the neck, limitation of neck movements, and a low posterior hairline. There are often accompanying cervical spinal abnormalities such as kyphoscoliosis as well as urogenital and cardiac abnormalities. Presented here we have a 20 year old young man with hypoesthesia and decreased motor function in the right hand. The problem began one year back following a minor head trauma and had a progressive course involving the legs, especially the feet. Cervical magnetic resonance imaging was compatible with C3-C4 cord compression as well as blocked vertebrae. The patient was evaluated to be in Mallampati class II. Endotracheal intubation was performed employing gentle manual axial traction in both anterior and posterior operative approaches without any neurological sequela. It is recommended that in situations where fiberoptic or Bullard laryngoscopes are not available and Mallampati class is low, direct laryngoscopy associated with gentle axial traction may be a plausible substitute