Anesthetic Management of a Syndromic Child with Difficult Airway for Debulking of Fibrous Dysplasia: A Case Report

Abstract

Background: Children with craniofacial syndromes present unique anesthetic challenges due to abnormal facial anatomy, airway involvement, and systemic associations. We report the anesthetic management of a 14-year-old boy with McCune-Albright syndrome and polyostotic fibrous dysplasia involving the mandible and facial bones, who presented for debulking surgery. His history included prior transnasal endoscopic excision and optic nerve decompression. Airway examination revealed limited visualization, flat facial features, and increased intercanthal distance, suggesting possible intubation difficulty. Despite the challenges, careful preoperative assessment, optimization, and preparation of airway adjuncts allowed successful induction and airway management. This case highlights the importance of vigilance, anticipation of airway compromise, and multidisciplinary planning in managing syndromic children undergoing craniofacial surgery.