Amniotic Band Syndrome With Congenital Absence of the Nose and Upper Lip: A Dental Anesthesia Challenge-A Case Report.

Amniotic Band Syndrome (ABS) is a congenital disorder which is caused by the entrapment of fetal parts in fibrous amniotic bands while in utero. It is found in 1 in 1200 to 15000 live births. There is no gender or ethnic predisposition. Abnormalities can involve the cranium, face, trunk, abdomen, and extremities. Extremities are the most frequently affected parts, which appear as absence of digits, abnormally developed extremities, or amputations. The prognosis depends on the severity of manifestations, ranging from mild to lethal abnormalities. The purpose of this report is to discuss a rare case of a patient with ABS, a profound intellectual disability, and associated craniofacial abnormalities such as the congenital absence of the nose and upper lip, which introduced significant challenges to dental anesthesia for a comprehensive dental examination and management. A preoperative anesthesia assessment must consider the patient's medical diagnosis, daily medication regimen, physical and airway status, PONV risk, prior anesthetic interventions, and other factors related to the patient's condition. Therefore, we must consider the extent of physical abnormalities present and any reconstruction reported when selecting the type of anesthesia and supporting airway devices.