Unanticipated compression of the trachea in a 5-month-old undergoing an MRI for evaluation of neurofibromatosis

Neurofibromatosis type 1 is an autosomal-dominant disorder with the tendency toward the formation of tumors. Plexiform neurofibromas are the most common type of tumors seen in neurofibromatosis type 1. Approximately 50% oeeur in the head and neek region with a 5% ineidenee of airway involvement. We describe the ease of a 5 month old with a plexiform neurofibroma of the neek who developed complete airway obstruction on induction of anesthesia. Magnetic resonance imaging revealed a skull base neurofibroma extending to the hypopharynx and resulting in deviation of the airway. Because of the possibility of airway involvement, a eareful preanesthetic evaluation as well as a slow induction with the maintenance of spontaneous ventilation should be considered in patients presenting with facial neurofibromas.