Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-28T04:48:05.115Z Has data issue: false hasContentIssue false
  • English
  • Français

Neonatal and paediatric fibre-optic laryngoscopy and bronchoscopy using the laryngeal mask airway

Published online by Cambridge University Press:  29 June 2007

A. E. Hinton ,
J. M. O'Connell ,
J. P. Van Besouw  and
M. E. Wyatt
A. E. Hinton*
Affiliation:
Department of Otolaryngology, St George's Hospital, London, UK.
J. M. O'Connell
Affiliation:
Department of Otolaryngology, St George's Hospital, London, UK.
J. P. Van Besouw
Affiliation:
Department of Anaesthesia, St George's Hospital, London, UK.
M. E. Wyatt
Affiliation:
Department of Otolaryngology, St George's Hospital, London, UK.
*
Address for correspondence: A. Hinton, F.R.C.S., Department of Otolaryngology, St George's Hospital, London SW17 0QT. Fax: 0181 725 3306
Get access Rights & Permissions [Opens in a new window]

Abstract

Endoscopy of the upper airways in neonates and infants has traditionally been accomplished using rigid laryngoscopes and bronchoscopes. The laryngeal mask may be used both to control the airway for anaesthetic ventilation and to guide a fibre-optic endoscope to the laryngeal inlet and beyond.

We report our experience with five neonatal and paediatric cases where fibre-optic laryngoscopy and bronchoscopy were performed through the laryngeal mask airway. All were cases in which standard rigid endoscopy had proved difficult with only a poor and restricted view of the laryngeal inlet being obtained due to the age of the infants, or abnormal anatomy of the upper airways.

No problems have been encountered with maintenance of the airway or with the endoscopic view obtained. In fact in neonatal patients, this technique has been found to be preferable with regard to safety and ease of use when compared to the ventilating bronchoscope. With the size 1 laryngeal mask airway it is not possible to simultaneously ventilate and endoscope the patient. Cases included, a vascular ring, Goldenhar's syndrome, laryngomalacia, supraglottis and vocal fold paresis.

This technique provides a secure method of maintaining anaesthetic ventilation during airway endoscopy, and also a means of easily locating the glottis.

Keywords

LaryngoscopyBronchoscopyInfant
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 4 , April 1997 , pp. 349 - 353
Copyright
Copyright © JLO (1984) Limited 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Asai, T., Morris, S. (1994) The laryngeal mask airway: its features, effects and role. Canadian Journal of Anaesthesia 41: 930–960.CrossRefGoogle ScholarPubMed
Brain, A. I. J. (1983) The laryngeal mask—a new concept in airway management. British Journal of Anaesthesia 55: 801–805.CrossRefGoogle ScholarPubMed
Dexter, T. J. (1994) The laryngeal mask airway: a method to improve visualization of the trachea and larynx during fibreoptic assisted percutaneous tracheostomy. Anaesthesia and Intensive Care 22: 35–39.CrossRefGoogle ScholarPubMed
Dich, N. J., Nagel, P. (1993) Flexible fibreoptic bronchoscopy via the laryngeal mask. Acta Anaesthesiologica Scandinavica 37: 17–19.CrossRefGoogle Scholar
Dubreuil, M., Laffon, M., Plaud, B., Penon, C., Ecoffey, C. (1993) Complications and fiberoptic assessment of size 1 laryngeal mask airway. Anesthesia and Analgesia 76: 527–529.CrossRefGoogle ScholarPubMed
Efrat, R., Kadari, A., Katz, S. (1994) The laryngeal mask airway in pediatric anesthesia: experience with 120 patients undergoing elective groin surgery. Journal of Pediatric Surgery 29: 206–208.CrossRefGoogle ScholarPubMed
Golisch, W., Honig, J. F., Lange, H., Braun, U. (1994) Difficult intubation due to facial malformations in a child. The laryngeal mask as an aid. Anaesthetist 43: 753–775.Google Scholar
Hansen, T. G., Joensen, H., Henneberg, S. W., Hole, P. (1995) Laryngeal mask airway guided tracheal intubation in a neonate with the Pierre Robin syndrome. Acta Anaesthesiologica Scandinavica 39: 129–131.CrossRefGoogle Scholar
Johnson, C. M., Sims, C. (1994) Awake fibreoptic intubation via a laryngeal mask in an infant with Goldenhar's syndrome. Anaesthesia and Intensive Care 22: 194–197.CrossRefGoogle Scholar
Maekawa, N., Mikawa, K., Tanaka, O., Goto, R., Obara, H. (1991) The laryngeal mask may be a useful device for fibreoptic airway endoscopy in pediatric anesthesia. Anaethesiology 75: 169–170.CrossRefGoogle ScholarPubMed
Mason, D. G., Bingham, R. M. (1990) The laryngeal mask airway in children. Anaesthesia 45: 760–763.CrossRefGoogle ScholarPubMed
Nandi, P. R., Nunn, J. F., Charlesworth, C. H., Taylor, S. J. (1991) Radiological study of the laryngeal mask. European Journal of Anaesthesiology (Suppl 4): 33–39.Google ScholarPubMed
Stott, S., Riley, R. (1994) Visualizing the airway after thyroidectomy [letter]. Anaesthesia and Intensive Care 22: 121.Google ScholarPubMed
Watcha, M. F., Garner, F. T., White, P. F., Lusk, R. (1994) Laryngeal mask airway vs face mask and Guedel airway during pediatric myringotomy. Archives of Otolaryngology, Head and Neck Surgery 120: 877–808.CrossRefGoogle ScholarPubMed
Webster, A. C., Morley, F. P., Dain, S., Ganapathy, S., Ruby, R., Au, A., Cook, M. J. (1993) Anaesthesia for adenotonsillectomy: a comparison between tracheal intubation and the armoured laryngeal mask airway. Canadian Journal of Anaesthesia 40: 1171–1177.CrossRefGoogle ScholarPubMed
Yahagi, N., Kumon, K., Tanigami, H. (1994) Bronchial lavage with a fibreoptic bronchoscope via a laryngeal mask airway in an infant. Anaesthesia 49: 450.CrossRefGoogle Scholar