Nörofibromatozis Tip 1 Tanılı Gebede Elektif Sezaryen Operasyonunda Spinal Anestezi Yönetimi

Nörofibromatozis Tip 1 (NF-1) ektodermal ve mezodermal dokulardaki yaygın etkileri nedeniyle otozomal dominant geçiş gösteren kalıtsal bir hastalık grubudur. Periferik sinirlerde multipl nörofibromlar ile karakterize olan hastalıkta kutanöz pigmente lekeler (cafe au lait spots) mevcuttur. Bu nörofibromlar sadece sinir sisteminde değil, orofarinks ve larinkste de bulunarak laringoskopiyi ve endotrakeal entübasyonu zorlaştırabilir. Bu olgu sunumuyla NF-1 tanılı gebe kadında elektif sezaryen operasyonunda spinal anestezi uygulamamızı sunmayı amaçladık.

___

  • Fox CJ, Tomajian S, Kaye AJ, Russo S, Abadie JV, Kaye AD. Perioperative Management of Neurofibromatosis Type 1. The Ochsner Journal. 2012, 12(2): 111-21.
  • Aldrovandi, Ulysses, Bartholomaeus Ambrosinus, and Marcus A. Bernia. Monstrorum historia: cum paralipomenis historiae omnium animalium. 1988.
  • Smith RW: A treatise on thepathology, diagnosis and treatment of neuroma. Clinical Orthopaedics and Related Research. 1989; 245: 3-9.
  • Fulton JF: Robert W. Smith's description of generalized neurofibromatosis (1849). New England Journal of Medicine 1929; 200(26): 1315-17.
  • Li Y, O'connell P, Breidenbach HH, Cawthon R, Stevens J, Xu G, Neil S, Robertson M, White R, Viskochil D: Genomic organization of the neurofibromatosis 1 gene. Genomics. 1995; 25(1): 9-18.
  • Deimling A, Krone W, Menon AG: Neurofibromatosistype 1: Pathology, clinical features and molecular genetics. Brain Pathology. 1995, 5(2): 153-62.
  • Lee WY, Shin YS, Lim CS, Chung WS, Kim BM: Spinal anesthesia for emergency cesarean section in a preeclampsia patient diagnosed with type 1 neurofibromatosis. Korean Journal of Anesthesiology. 2013; 65(6 Suppl): S91-S92.
  • Sakai T, Vallejo M, Shannon K. A parturient with neurofibromatosis type 2: anesthetic and obstetric considerations for delivery. International Journal of Obstetric Anesthesia 2005, 14(4): 332-5.
  • Pemov A, Sung H, Hyland PL, Sloan JL, Ruppert SL, Baldwin AM, Boland JF, Bass SE, Lee HJ, Jones KM. Genetic Modifiers of Neurofibromatosis Type 1-Associated Café-au-Lait Macule Count Identified Using Multi-platform Analysis. PLoS Genetics. 2014, 10(10): e1004575.
  • Fortman BJ, Kuszyk BS, Urban BA, Fishman EK: Neurofibromatosis Type 1: A Diagnostic Mimicker at CT 1. Radiographics. 2001, 21(3): 601-12.
  • Hirsch N, Murphy A, Radcliffe J: Neurofibromatosis: clinical presentations and anaesthetic implications. British journal of anaesthesia 2001, 86(4): 555-564.
  • Cranshaw J, Morgan C, Knowles G, Nicholson A, Goldstraw P: Intramural neurofibroma of the trachea treated by multiple stents. Thorax. 2001; 56(7): 583-4.
  • Moorthy SS, Radpour S, Weisberger EC. Anesthetic management of a patient with tracheal neurofibroma. Journal of Clinical Anesthesia. 2005; 17(4): 290-92.
  • Irion KL, Gasparetto TD, Marchiori E, Hochhegger B, Rubin AS: Neurofibromatosis type 1 with tracheo bronchial neurofibromas: case report with emphasis on tomographic findings. Journal of Thoracic Imaging. 2008; 23(3): 194-6.
  • Willmann JK, Weishaupt D, Kestenholz PB, vonSmekal A, Marincek B. Endotracheal neurofibroma in neurofibromatosistype 1: an unusual manifestation. Europeanradiology. 2002; 12(1): 190-2.
  • Arazi-Kleinmann T, Mor Y, Brand N, Gayer G. Neurofibromatosis diagnosed on CT with MR correlation. Europeanjournal of Radiology. 2002; 42(1): 69-73.
  • Zencirci B. Safe performance of spinal anesthesia in a critical patient with neurofibromatosis, pectus carinatum, and temporomandibular joint dysfunction: A case report. Patient Saf Surg. 2010; 4(1): 7. doi: 10.1186/1754-9493-4-7.
  • Dounas M, Mercier FJ, Lhuissier C, Benhamou D, Crochetière C, Muir H. Epidural analgesia for labour in a parturient with neurofibromatosis. Canadian Journal of Anaesthesia. 1995; 42(5): 420-4.
  • Spiegel J, Hapgood A, Hess P. Epiduralanesthesia in a parturient with neurofibromatosistype 2 under going cesarean section. International Journal of Obstetric Anesthesia. 2005; 14(4): 336-9.
  • Wulf H, Brinkmann G, Rautenberg M. Management of the difficult airway A case of failed fiberoptic intubation. Acta Anaesthesiologica Scandinavica. 1997; 41(8): 1080-82.
  • Akbarnia BA, Gabriel KR, Beckman E, Chalk D. Prevalence of scoliosis in neurofibromatosis. Spine. 1992; 17: 244-48.