Although manifestations of neurofibromatoses are often mild, there may be associated pathology of direct relevance and importance to the anaesthetic management.

A 20years old male k/c/o Von Recklinghausen’s Neurofibromatosis, was posted for congenital left sided dorsolumbar kyphoscoliosis correction. After induction of anaesthesia, on laryngoscopy a mass inferior to the epiglottis and coursing posterolaterally over the right aryepiglottic fold was visualized. As the chink was adequate patient could be intubated with cuffed endotracheal tube with I.D. 8.5mm. Surgery was performed under GA in prone position for 6 hours.

Intraoperative course was uneventful, patient was well reversed and extubated. But immediately post extubation patient developed stridor hence was reintubated , shifted to ICU on T-piece. Patient was extubated after 24 hours with emergency tracheostomy standby.

Airway obstruction during induction and post-extubation should be anticipated and a systematic approach to the pre‐operative assessment of these patients is essential for rational perioperative management