Hemifacial microsomia: An anesthetic airway problem

Hemifacial microsomia is a rare congenitally acquired dentofacial deformity characterized by unilateral hypoplasia of the hard and soft tissues of the face and cranium. Associated anomalies of the vertebrae and hypopharynx cause perioperative airway management to be difficult. The case of a patient with severe hemifacial microsomia, cervical spine fusion, and temporomandibular joint ankylosis is presented, with special emphasis on anesthetic airway management. A device to aid fiberoptic nasolaryngoscopy when difficult endotracheal intubations are encountered is described.