It is generally agreed upon that a difficult airway is a situation when problems exist in establishing adequate ventilation via mask or artificial airway. This situation can be both unanticipated and anticipated. The scope of this discussion will consist of the anticipated difficult airway caused from genetic syndromes with craniofacial disorders. Early recognition of these syndromes increases the likelihood of a possible difficult airway being identified and proper preparation occurring. This includes both proper equipment and additional skilled personnel.

There are multiple challenges involved in managing the airway of a patient with craniofacial disorders. A thorough understanding is needed of the normal anatomy, including both bony structures and soft tissue, and how these are affected by various disorders. The resulting abnormalities can affect airway management: ventilation, intubation, or both. Well-known congenital disorders that can affect the anatomy of the airway include Pierre Robin syndrome, Treacher Collins syndrome, Klippel-Feil syndrome, Beckwith-Wiedemann syndrome, Trisomy 21, Freeman-Sheldon syndrome, Goldenhar syndrome, craniofacial dysostosis (Apert syndrome), as well as mucopolysaccharidosis syndromes that include Hunter and Hurler syndromes. Following is a brief discussion of these disorders and their associated anatomic abnormalities.