Anesthetic and Surgical Management of a Bilateral Mandible Fracture in a Patient With Charcot-Marie-Tooth Disease: A Case Report

• Published in: Journal of oral and maxillofacial surgery Vol. 73; no. 10; pp. 1917.e1 - 1917.e6
• Main Authors: Smith, Jeffrey D., DDS, Minkin, Patton, DDS, Lindsey, Sean, DDS, Bovino, Brian, DMD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2015
• Subjects: Aged; Anesthesia; Charcot-Marie-Tooth Disease - surgery; Dentistry; Humans; Male; Mandibular Fractures - diagnostic imaging; Mandibular Fractures - surgery; Radiography, Panoramic; Surgery
• ISSN: 0278-2391; 1531-5053
• DOI: 10.1016/j.joms.2015.06.162

Purpose This report describes the case of a 74-year-old man who had been diagnosed with Charcot-Marie-Tooth disease as a child. Because the patient had serious motor and sensory neuropathy associated with his disease, special anesthetic and surgical recommendations had to be considered before he underwent general anesthesia to repair his mandibular fracture. Materials and Methods Repair of the mandible was performed under general anesthesia with a nasal endotracheal tube and the use of the nondepolarizing muscle relaxant rocuronium. Open reduction and internal fixation through extraoral approaches were used to fixate the displaced right subcondylar and symphyseal fractures. A closed reduction approach using maxillary fixation screws and a mandibular arch bar with light elastic guidance was used to treat a nondisplaced fracture of the left mandibular ramus. Rigid fixation allowed for avoidance of a period of intermaxillary fixation. Results General anesthesia and muscle relaxant were administered without complication. Treatment of bilateral mandibular fractures with combined open and closed approaches resulted in restoration of premorbid occlusion and masticatory function. Conclusion Repair of mandibular fractures under general anesthesia appears to be a safe procedure in patients with Charcot-Marie-Tooth disease when appropriate anesthetic and surgical methods are used.