Surgical Treatment of Oroantral Fistula in a Patient with Myasthenia Gravis: Clinical Considerations and Anesthetical Management

Clinical and Anesthetical Management in a Patient with Myasthenia Gravis

Abstract

Myasthenia gravis (MG) is a autoimmune neuromuscular disease that presents muscle weakness and fatigue. MG affects neuromuscular junction and is characterized by the  development of antibodies (IgG) against postsynaptic acetylcholine receptors cause disease. Definitive diagnosis is made by electromyogram (EMG). Women are more affected than men. Autoimmune diseases including rheumatoid arthritis, systemic lupus erythematosis, and pernicious anemia are reported in about 5% of patients. Fluctuating weakness and easy fatigability of skeletal muscles are observed when limbs are involved. The weakness may involve a single muscle group or be generalized. The muscle group is the ocular muscles and often causes diplopia and ptosis. On this rare occasion, careful perioperative anesthetic management are should made to avoid life-threatening complications in both intraoperative and postoperative periods.

In this case report, a 47-year-old female patient with MG requiring oroantral fistula treatment is described. The anesthetic management was made under local anesthesia using appropriate dose and the postoperative patient follow-up was uneventful.