Anesthetic Challenges in Ameloblastoma of the Mandible: A Case Report

TL;DR

This case report describes the anesthetic and surgical management of a rare jaw tumor in a young boy, emphasizing airway challenges and successful treatment strategies.

Contribution

The report highlights the effectiveness of the BURP maneuver and prophylactic tracheostomy in managing airway challenges during ameloblastoma surgery in pediatric patients.

Findings

The BURP maneuver successfully facilitated intubation in a pediatric patient with mandibular ameloblastoma.

Prophylactic tracheostomy ensured postoperative airway patency and allowed successful ventilatory weaning by day four.

Wide local excision and reconstruction were performed without major complications in this rare pediatric case.

Abstract

Ameloblastoma is a rare, locally aggressive benign tumor primarily affecting the mandible, with an incidence of 0.92 cases per million person-years and a male predominance.

A two-year-old male presented with a right mandibular mass. CT imaging and histopathology confirmed ameloblastoma. He underwent wide local excision, mandibulectomy, and pectoralis major myocutaneous flap reconstruction under general anesthesia. Preoperative assessment revealed potential airway challenges; intubation was achieved with the backward, upward, rightward pressure (BURP) maneuver, and tracheostomy was performed to secure postoperative airway patency. The surgery was uneventful, and the patient was successfully weaned off ventilatory support by postoperative day four. This case underscores the importance of careful planning and expertise in pediatric ameloblastoma management, highlighting the effectiveness of direct laryngoscopy with BURP maneuver and prophylactic tracheostomy.

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