Anaethetic management of a neonate with huge cystic hygroma

We discuss here the case of a 7 day old neonate with huge cystic hygroma on the left side of the neck invading the major vessels of neck, facial nerve, strap muscles and sternocleidomastoid. Anasethtic implications in this case were maintaining airway patency after induction, difficult intubation, risk perioperative dislodgement of tube and judgement of proper time for extubation. Following gaseous induction and adequate mask ventilation, patient was intubated with muscle relaxant. peroperatively to avoid accidental extubation, we choose to manually hold the ET tube after fixing it. At the end of relatively uneventful surgery, we could extubate the patient in OT. patient was shifted to NICU for observation. Post operatively on 3rd day, facial palsy was observed. Ptient was discharged on 21st day.