Emergency airway management in a child with malignant infantile osteopetrosis

[2] Anesthetic management of malignant infantile osteopetrosis involves the management of several risks related to clinical manifestations and complications that might contribute to increased morbidity and mortality: neurologic and hematologic complications and airway difficulty. Insertion of a nasal tube was impossible and laryngoscopy was difficult because of limited mouth opening with small interincisor distance and also because there was a bone-like mass on the epiglottis obstructing the upper airway tract and bleeding on contact. {Figure 1} Past medical history included malignant osteopetrosis with failure to thrive, hepatosplenomegaly, blindness, deafness, and myelopathies requiring iterative blood transfusions; stem cell transplant being in its infancy.