ANESTHETIC CONSIDERATIONS IN A PATIENT WITH PARRY-ROMBERG SYNDROME UNDERGOING FACIAL RECONSTRUCTION WITH AUTOLOGOUS FAT GRAFTING: A CASE REPORT

Parry - Romberg syndrome is a rare disorder characterized by progressive hemifacial atrophy. Altered facial contours may impair mask seal, while associated maxillomandibular abnormalities and neurological manifestations may influence anesthetic planning. We report the case of a 38-year-old man with no known medical history and no previous surgery who underwent facial autologous fat grafting. Preoperative examination showed facial asymmetry, preserved mouth opening, Mallampati class II, a thyromental distance greater than 65 mm, and normal cervical mobility. Craniofacial computed tomography showed no skeletal abnormalities of the right hemiface. Anesthesia was induced with fentanyl 250 µg, propofol 200 mg, and rocuronium 50 mg. Mask ventilation was easy. Orotracheal intubation with a video laryngoscope and a 7.5-mm reinforced tube was easy (Cormack-Lehane grade II), and anesthesia was maintained with sevoflurane at 2%. Adipose tissue was harvested from the lateral aspect of the right thigh.