Cranial conjoined twins: surgical and anesthetic challenges for a routine procedure: adenoidectomy and examination of ears.

Craniopagus conjoined twins have long been the subject of interest because of the rarity and peculiarity of their juxtaposition. We present the surgical, airway and anesthetic challenges in craniopagus conjoined twins, in which one of the twins underwent adenoidectomy for obstructive sleep breathing disorder. The surgical procedure required a special setting from an anesthetic perspective whereby both children needed anesthesia due to the complex physiology of their brains and cardiovascular systems. As well, we took the opportunity to do bilateral ear examinations of both twins.