Abstract Fibrous dysplasia (FD) is a benign fibro-osseous disorder characterized by replacement of normal bone with fibrous tissue and disorganized woven bone. Craniofacial involvement is common and may create significant anesthetic and surgical challenges. We report the perioperative management of a 28-year-old male with sino-orbital FD who underwent bifrontal craniotomy and anterior cranial fossa repair for progressive right orbital proptosis. Preoperative evaluation revealed frontal bossing and a Mallampati grade III airway without other systemic abnormalities. Given the overlap of craniofacial FD with features of acromegaly and its association with McCune–Albright syndrome, a detailed endocrine assessment was performed, which was normal. Key components of management included meticulous airway planning with advanced adjuncts, careful positioning to avoid fractures, and readiness for blood loss. Cautious extubation after full recovery, with close postoperative monitoring, should be done. This case emphasizes the importance of comprehensive preoperative evaluation, multidisciplinary coordination, and vigilant airway management to optimize perioperative outcomes in craniofacial FD.
Priyadarshini et al. (Fri,) studied this question.