Abstract

Silver-Russel syndrome (SRS) is a rare syndrome which is characterized by growth and developmental retardation, clinodactyly of the fifth finger and a triangular face shape. A 3.5-year-old male patient who was followed with the diagnosis of SRS was admitted to our clinic with the complaints of snoring, nasal obstruction and sleep apnea. Physical examination and other assessments revealed an adenotonsillar hypertrophy and right otitis media with effusion as well as SRS symptoms. A right ventilation tube was inserted and adenotonsillectomy (AT) was performed. During the operation, bradycardia occurred when the mouth gag was placed. Bradycardia which was possibly due to vagal irritation resolved with the placement of the tongue to one side and insertion of the mouth gag. During his follow-up, his growth rate increased. In patients with SRS, early diagnosis and treatment of obstructive sleep apnea syndrome is of utmost importance. During AT in SRS patients with growth retardation and micrognathism, the restricted oral cavity volume should be considered, the surgeon should be careful during the placement of the mouth gag, and the anesthesiologists should be ready for possible complications such as bradycardia.