Anesthetic Management of a Juvenile Hyaline Fibromatosis Patient With Trismus and Cervical Movement Limitation

Anesthetic Management of a Patient With Juvenile Hyaline Fibromatosis: A Case Report Written With the Assistance of the Large Language Model ChatGPT

This case report was written with the assistance of the large language model known as ChatGPT, a form of generative artificial intelligence that can write grammatically correct and semantically meaningful prose on a multitude of topics. Here, it has assisted us in presenting a case of anesthetic management for a case of Juvenile Hyaline Fibromatosis (JHF), an extremely rare genetic disorder that is part of a spectrum of diseases presently characterized as Hyaline Fibromatosis Syndrome (HFS), which also includes a more severe variant presenting in infancy. HFS is caused by autosomal recessive mutations in the ANTXR2 (anthrax toxin receptor cell adhesion molecule 2) gene, which binds collagen IV and laminin, suggesting that it may be involved in extracellular matrix adhesion. Defects in this molecule lead to abnormal deposition of hyaline material in perivascular areas, presenting as cutaneous lesions, joint contractures, and in some cases internal organ dysfunction. Anesthetic management of patients with JHF may present difficulties with patient positioning and airway management. Most reports of anesthetic management concern children with severe disease and adult reports are uncommon. We present a case of JHF in a 39-year-old woman managed for resection of a lower extremity cutaneous lesion. The anesthetic management of this relatively minor case was uneventful, but the process of drafting this report with the assistance of the new software tool ChatGPT was informative of both its strengths and limitations.

Diagnosis and management of temporomandibular joint dysfunction before surgery: a case report

We present a case of colorectal cancer with temporomandibular joint dysfunction and discuss the management of the case. Type IIIb temporomandibular disorder involves anterior dislocation of the articular disk, trismus and difficult intubation. A 68-year-old woman was scheduled for colectomy. The day before surgery, the patient had temporomandibular pain. On examination, the mouth opening was 13 mm. We diagnosed type IIIb temporomandibular disorder. A simple splint was fabricated with gauze and she bit it. The mouth opening was 55 mm on the day of surgery. The pain disappeared, and intubation was uneventful. Temporomandibular disorders are generally treated by dentists. It is beneficial for general hospitals without a dentistry department to employ a dental anaesthesiologist to assist in potentially difficult intubations in patients with temporomandibular disorders.