Airway Management in a Child Presenting with Syngnathia for Surgical Correction

Syngnathia is a rare disorder characterized by bony fusion of maxilla and mandible which can be unilateral, or bilateral.1,2,3,4 Only 24 cases have been reported since 1936. Airway management in case of surgery for syngnathia varies from observation or sedation only, up to full airway control. It is a formidable task for anaesthetist to manage anticipated difficult intubation.Management of difficult airway is challenging task for anaesthesiologist. We present a case of 5 yr. old female with syngnathia with a bony fusion of maxilla and mandible on right side. Multidisciplinary approach is used to manage the airway with step wise anticipation of each complication. Child is premedicated with oral promethazine, nebulisation given, followed by FOB by maintaining spontaneous ventilation in the child.