Anaesthesia for proximal femoral nailing in a patient with “Rosai Dorfman disease” with prior laryngotracheal reconstruction - Not all rosy as it seems

Rosai Dorfman disease is a rare disease with massive lymphadenopathy. It presents significant challenges to the anaesthesiologists involving multiple organs especially the airway. Here we present a patient who is a known case of Rosai Dorfman disease with severe hypothyroidism and Alzheimer's disease with previous history of laryngotracheal reconstruction, now presenting with femur inter trochanteric fracture for proximal femur nailing. A tailored approach with detailed preoperative evaluation and planning, emphasis on airway, with backup plan added to the successful management of this case.