Opitz-Frias Syndrome (The G Syndrome)


Risk

  • Overall incidence not reported

  • Very rare congenital disorder

Preoperative Risks

  • Very high risk of recurrent pulm aspiration; hypoplasia of both pulm and vascular components of one lung (pulm hypoplasia)

  • High mortality rate in infancy

Worry About

  • NM dysfunction of laryngoesophageal apparatus

  • Laryngotracheoesophageal cleft or fistula

  • Difficult tracheal intubation due to assoc craniofacial deformity

  • Assoc congenital anomalies (Htn, hypospadias, wide eyes, cleft lip, cleft palate, cryptorchidism, imperforate anus, cardiac deficits)

Overview

  • Also known as the hypospadias-dysphagia syndrome.

  • Emergency presentations are for cardiopulmonary resuscitation, upper respiratory obstruction, severe respiratory stridor, regurgitation, aspiration.

  • Presence of one hypoplastic lung.

  • Laryngeal hypoplasia.

  • Laryngotracheoesophageal cleft or fistula.

  • Anticipate very difficult tracheal intubation.

  • Thorough preop cardiac evaluation; need to assess for cardiac abnormalities (possible ECHO).

  • Any male infant presenting for tracheoesophageal fistula with genital defect should be suspected.

  • Classically: Weak, hoarse cry

Etiology

  • X-linked recessive inheritance.

  • Autosomal dominant inheritance or new mutation.

  • Partial male sex limitation.

  • Autosomal recessive inheritance, high parenteral consanguinity.

  • Females can be equally or nearly as severely affected as males.

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