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KMID : 1144020210170020033
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Journal of Korean Association for Disability and Oral Health
2021 Volume.17 No. 2 p.33 ~ p.38
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Dental Management of a Patient with Spinal Muscular Atrophy under Total Intravenous Anesthesia: A Case Report
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Cho Hye-Jin
Kim Hyun-Tae
Song Ji-Soo
Shin Teo-Jeon
Hyun Hong-Keun
Kim Jung-Wook
Jang Ki-Taeg
Kim Young-Jae
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Abstract
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Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease caused by mutations in the survival of motor neurons (SMN1) gene, located on chromosome 5q13. It affects 1 in 6,000 to 1 in 10,000 live births and is characterized by degeneration of lower motor neurons in the anterior horn in the spinal cord, resulting in muscle weakness and atrophy. Special care must be taken during general anesthesia due to weak respiratory muscles and hypersensitivity to muscle relaxants. This report describes dental treatment of a 6-year-11-months old boy with SMA type II under total intravenous anesthesia using propofol and remifentanil without the use of muscle relaxant. The patient exhibited malocclusions related to weak masticatory muscles and mouth breathing. Dental caries treatment with composite resin restoration and surgical extraction of impacted mesiodens was performed without any postoperative complications. The patient recovered fully from general anesthesia and was discharged on the day without the need of hospitalization.
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KEYWORD
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Spinal muscular atrophy, Total intravenous anesthesia, Dental treatment
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