Abstract

Babies with Pierre Robin syndrome have serious life-threatening risks because of acute respiratory distress and difficult airway management. It is difficult to perform endotracheal intubation in these babies for general anesthesia. We present successful insertion of laryngeal mask airway in a neonate with typical clinical features of Pierre-Robin syndrome using a size 1 laryngeal mask airway for a ventriculoperitoneal shunt operation. The patient had micrognathia, glossoptosis with cleft palate, and partial trismus. His mouth opening was restricted to 0.6 cm. Anesthesia was deepened with sevoflurane, maintaining spontaneous ventilation, but laryngoscopy was impossible because of the limited mouth opening. After unsuccessful attempts to insert an LMA by standard and rotational techniques, it was inserted using a novel modified rotational LMA insertion technique, which we have termed the ‘squeezing technique'.