Korean J Anesthesiol.  2003 Oct;45(4):528-532. 10.4097/kjae.2003.45.4.528.

Laryngeal Mask Airway as a Conduit for Fiberoptic Intubation and Tracheal Evaluation: 2 Cases report

• Go JE
• Shin IW
• Jung JH
• Shon JT
• Lee HK
• Chung YK

• KMID: 2299038
• DOI: http://doi.org/10.4097/kjae.2003.45.4.528

Abstract

The laryngeal mask airway (LMA) has several advantages over endotracheal intubation for the airway management in tracheal stenosis patients. Endotracheal tubes are narrower than the natural trachea and can induce reflex airway constriction resulting in more resistance to ventilation. Furthermore, an endotracheal tube can injure the trachea, and cause airway edema, and further tracheal constriction. In contrast, the increase in airway resistance that occurs when using the laryngeal mask is relatively low, because the diameter of the laryngeal mask airway is larger than that of the endotracheal tube and the laryngeal mask airway is not intubated. However, patients with a mechanically obstructed trachea, those with tracheomalacia or an external compression of the trachea, cannot be managed with a laryngeal mask airway, because it cannot prevent tracheal collapse. Thus it is important that the causes of tracheal obstruction are differentiated. This report suggests that the laryngeal mask airway can be used as a route for mechanical ventilation and as a conduit for tracheal evaluation and endotracheal intubation using fiberoptic bronchoscope during tracheal reconstruction surgery in patients with tracheal stenosis.

Keyword

laryngeal mask airway; tracheal evaluation; tracheal stenosis; tracheomalacia

MeSH Terms

Airway Management
Airway Resistance
Bronchoscopes
Constriction
Edema
Humans
Intubation*
Intubation, Intratracheal
Laryngeal Masks*
Reflex
Respiration, Artificial
Trachea
Tracheal Stenosis
Tracheomalacia
Ventilation