Malignant hyperthermia in the otolaryngologic patient

Malignant hyperthermia is a pharmacogenetic disorder initiated by exposure to a variety of anesthetic agents. The reaction has assumed major importance to the otolaryngologic surgeon because: 1. approximately 20 percent of all reported reactions have occurred during anesthesia for ENT surgical procedures; 2. the disorder is being reported with increasing frequency; and 3. mortality associated with the reaction is greater than 60 percent. Susceptible patients appear to have a disorder of muscle, but because genetic penetrance and expression are limited, manifestations are often mild, and physical manifestations variably present. The authors suggest an approach leading to early detection of the susceptible patient.