Airway management and endoscopic treatment of subglottic and tracheal stenosis: The laryngeal mask airway technique

Nopawan Vorasubin, Darshni Vira, Nausheen Jamal, Dinesh K. Chhetri

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: The objective is to present clinical outcomes of subglottic and tracheal stenosis treated by flexible bronchoscopic delivery of carbon dioxide (CO2) laser via laryngeal mask airway (LMA). Methods: All consecutive, nontracheotomy dependent cases of subglottic and tracheal stenosis treated endoscopically over a 4-year period were retrospectively reviewed. The surgical approach consisted of radial incisions using a flexible fiber-based CO2 laser, balloon dilation, and topical application of mitomycin C. Ventilation during the procedure occurred through the LMA, and the CO 2 laser fiber was delivered through the working channel of a flexible bronchoscope passed through the LMA. Number of dilations, period between dilations, and operative times were reviewed. Results: Eleven patients who underwent airway intervention during the study period were identified. Average follow-up was 28 months. Etiologies of airway stenosis included intubation injury (6), idiopathic (4), or autoimmune disease (1), requiring an average of 1.3, 1.5, and 3 dilations, respectively. Average operative time was 67 minutes. Autoimmune etiology correlated with more frequent dilations. Conclusion: LMA is an effective way to manage ventilation while simultaneously allowing unencumbered flexible bronchoscopic access for laser surgery, balloon dilation, and mitomycin C application for airway stenosis. Long-term success in treating stenosis is achievable using this technique.

Original languageEnglish (US)
Pages (from-to)293-298
Number of pages6
JournalAnnals of Otology, Rhinology and Laryngology
Volume123
Issue number4
DOIs
StatePublished - Apr 2014
Externally publishedYes

Keywords

  • Airway management
  • Balloon dilation
  • Laryngeal mask airway
  • Subglottic stenosis
  • Tracheal stenosis

ASJC Scopus subject areas

  • Otorhinolaryngology

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