Patients with Poland syndrome do not often have
any functional disability and can present either for diagnostic radiological
procedures or for cosmetic breast reconstructive surgery. Associated
anomalies may include cardiovascular (dextrocardia, atrial septal defect),
musculoskeletal (scoliosis), genitourinary (renal aplasia, hypospadias,
inguinal hernia), gastrointestinal (extension of liver through chest), and
hematological (lymphoma, leukemia). Patients with Moebius syndrome have
congenital paralysis of the sixth and seventh cranial nerves, resulting in
esotropia and facial paralysis. Occasionally, cranial nerves V, X, XI, and
XII are also involved, resulting in chewing, swallowing, and coughing, and
repeated aspiration with respiratory complications. Patients with Moebius
syndrome have a high incidence of other anomalies, including congenital
cardiac disease, spinal anomalies, corneal abrasions, and peripheral
neuropathies, and a careful preoperative assessment is essential. Affected
children most commonly present for anesthesia for correction of strabismus,
or for orthopedic procedures to improve limb function.