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

## TL;DR

This case report highlights the anesthetic challenges faced when managing an adult with Moebius syndrome, emphasizing the need for careful airway planning.

## Contribution

The paper presents a rare case of difficult airway management in an adult with Moebius syndrome, which is typically reported in children.

## Key findings

- The patient's airway classification worsened over time despite prior successful intubations.
- Fiberoptic intubation failed, but a combination of dexmedetomidine and video laryngoscopy was successful.
- The case underscores the importance of tailored airway strategies for adults with Moebius syndrome.

## Abstract

Moebius syndrome (MBS) 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 MBS during an elective procedure, which is unique as most reports of MBS are in children.

Our patient was a 30‐year‐old male diagnosed with MBS 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 Mallampati Classes 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.

Our case demonstrates the necessity of preparing for a difficult airway and strategies for airway management in an adult with MBS.