Bifid epiglottis: What perioperative physician should know a
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A 7-year-old male child visited preoperative clinic for preanesthetic evaluation. He was posted for urological procedure. On history, he was first child of normal parents. On examination, he was 35 kg in weight and having course facial features. At birth, he was diagnosed to have high anorectal malformations (ARMs), penoscrotal hypospadias, polydactyly, bilateral congenital talipes equinovarus, and left renal agenesis. Child's mental progress was also not aged appropriate. He has undergone surgery for high ARM at birth uneventfully. His clinical examination and laboratory investigations were within normal limits. His chest radiograph, 12 lead electrocardiography and two-dimensional echocardiography were also normal. Hormonal assay showed a testosterone level of 1.6 nmol/L. No chromosomal abnormality was diagnosed on karyotyping. Airway examination revealed a mouth opening of 2 cm with large tongue. Previous anesthesia records were not available. Routine anesthesia induction was done with sevoflurane in oxygen, 70 μ fentanyl, and 20 mg atracurium. On direct laryngoscopy for tracheal tube advancement, a bifid epiglottis with complete slit up to base of epiglottis was seen...

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