Anesthetic Challenges of Caring for an Adult with Moebius Syndrome: A Case Report

Abstract Background Moebius syndrome is a rare congenital disorder with facial nerve palsies and craniofacial malformations, increasing the risk of a difficult airway during anesthesia. We report a difficult airway in an adult with Moebius syndrome during an elective procedure, which is unique as most reports of Moebius syndrome are in children. Case Presentation Our patient was a 30-year old male diagnosed with Moebius syndrome at birth, and presented with craniofacial and orthopedic malformations, intellectual disability, and facial nerve palsies. Although our patient had prior successful intubations, their airway exam deteriorated from a Mallampati Class II to IV after many surgeries. After fiberoptic intubation with nebulized lidocaine to maintain spontaneous ventilation failed, an attempt with dexmedetomidine and video laryngoscopy was successful. Conclusion Our case demonstrates the necessity of preparing for a difficult airway and strategies for airway management in an adult with Moebius Syndrome.