We experienced a patient with hemifacial microsomia who accompanied with a difficulty in the endotracheal intubation for general anaesthesia in the course of parotid tumor resection. The patient was found to have an anomalous hyoid and bilaterally-elongated styloid processes. The computed radiography was more effective than the conventional radiography for evaluating anatomical anomalies of the neck because it can image both of the soft and hard tissues of the neck. These anomalies were thought to be an expression of oculo-auriculo-vertebral spectrum including hemifacial microsomia, although they rarely have been noticed. The difficult intubation might be caused by the restricted mobility of the hyoid due to the anomalies.
