SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact. SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field. Von Recklinghausen disease or neurofibromatosis Type I NF1 is an autosomal dominant disease with a wide spectrum of clinical manifestations.
Neurofibromas are the characteristic lesions. This disorder is associated with important anaesthetic considerations, mainly when neurofibromas occur in the oropharynx and larynx, leading to difficult laryngoscopy and tracheal intubation.
We describe the anaesthetic management of a patient with NF1 under general anaesthesia for facial neurofibroma excision. We performed a brief review of the literature with the aim of optimizing the anaesthetic management and reducing the number of complications associated with the systemic manifestations of this syndrome. Von Recklinghausen disease VR or neurofibromatosis type I NF1 is an autosomal dominant disorder characterized by the propensity to form ectodermal and mesodermal tissue tumours, 1 affecting primarily the nervous system and the skin.
We present a case of a year-old patient with a personal history of VR and a surgical history of excision of a right hemicranial plexiform neurofibroma. No fibromas of the oral cavity or predictors of a difficult airway were found during airway exploration. The patient did not report dyspnoea, dysphagia or changes in voice tone that could suggest the presence of laryngeal fibromas. Additional tests included biochemistry, whole blood count, coagulation tests and a chest radiograph, all of which came back normal.
The patient presented important facial asymmetry as a result of multiple retroauricular neurofibromas that disfigured the face and made it impossible for him to use reading glasses. It was decided to excise the neurofibromas and attempt facial remodelling. There was no airway obstruction after induction during manual ventilation with a facial mask. Endotracheal intubation proceeded uneventfully and mechanical ventilation was instituted.
