Osseous torticollis may be associated with a difficult airway that may be a challenge if intubation is needed.
Osseous torticollis refers to torticollis associated with bone disorder, such as congenital or acquired deformity or malformation of the cervical spine. This results in an abnormal head and neck posture.
Key decision areas:
(1) difficulty of initial intubation
(2) presence of comorbid conditions that may further compromise the airway
(3) the decision to extubate needs to be made carefully
(4) there should be a contingency plan if it fails, with necessary supplies readily accessible
(5) prompt reintubation after extubation if needed
(6) decision-making for tracheostomy
Comorbid factors that may contribute to a difficult airway:
(1) difficulty extending the cervical spine
(2) short neck
(3) enlarged tonsils and/or adenoids
(4) airway edema (which may develop in the early postoperative period)
(5) obesity
(6) Chiari malformation
