Preventing Postoperative Respiratory Problems in Chiari Malformation 1 and the Crucial Role of Peroperative Positioning: Technical Nuances and Philosophy

Author(s): Abu Saleh Mohammad Abu Obaida, Sheikh Forhad, A.K.M. Khalequzzaman, Sayem Al Monsur Faizi, Muhammad Fakhrul Islam, Abu Naim Wakil Uddin, Md. Ruhul Kuddus, Md. Mohiuddin Biswas, Md. Shamsul Alam, Asifur Rahman

Chiari Malformation 1 (CM1) surgery is as challenging as understanding its intricate pathophysiology. Syringomyelia (SM) which is often present and is closely related to the pathophysiology of CM1 makes surgery formidable. The pathology of CM1 poses challenges at every step in its entire perioperative period. Among many postoperative complications, respiratory arrest or respiratory distress is a relatively uncommon yet devastating one. Several factors may lead to postoperative respiratory problems which can be fatal. Understanding the intricate pathophysiology of the respiratory problem in CM1 is important. Here we discuss the probable pathophysiologies and an effective way to minimize those by being meticulous in the peroperative positioning of the patient.