# Multidisciplinary Airway Management and Postoperative Planning in a Pediatric Patient With Unrepaired Treacher-Collins Syndrome: A Case Report

## TL;DR

This case report details the challenges and successful airway management of a young child with Treacher-Collins syndrome who had not undergone corrective surgery.

## Contribution

The report highlights a novel approach using an adult-sized Ovassapian airway for successful intubation in a complex pediatric case.

## Key findings

- Ketamine facilitated vascular access and anesthetic depth in a pediatric TCS patient.
- An adult-sized Ovassapian airway enabled successful fiberoptic bronchoscope-guided intubation after multiple failures.
- Multidisciplinary collaboration improved postoperative airway management outcomes.

## Abstract

Treacher-Collins syndrome (TCS) presents significant challenges in airway management due to craniofacial abnormalities that often worsen with age. We describe the anesthetic management of a three-year-old male with TCS and no history of corrective surgery. Ketamine was used to facilitate vascular access and achieve adequate anesthetic depth. After three unsuccessful intubation attempts, an adult-sized Ovassapian airway was employed to guide a fiberoptic bronchoscope beneath the epiglottis and through the vocal cords, resulting in successful intubation. Postoperative airway management was optimized through multidisciplinary collaboration, highlighting the importance of preoperative planning and team-based decision-making in complex pediatric airway cases.