Oral surgery with nasotracheal intubation in a patient with ectodermal dysplasia.

Ectodermal dysplasias are a rare group of heritable disorders involving the ectodermal derivatives with only a few published reports involving its anaesthetic management. We present the case of a 16-year-old boy with ectodermal dysplasia presented for elective oral surgery under general anaesthesia with a surgeon preference for nasotracheal intubation to provide adequate surgical exposure. The patient had successful nasal flexible bronchoscopic intubation despite challenging tracheal intubation conditions. We summarise previous case reports and discuss anaesthetic considerations in ectodermal dysplasia , including reduced mucus production in the respiratory tract, laryngeal incompetence, potential for difficult tracheal intubation and hyperthermia from reduced or absent sweat glands.