Airway rescue with the intubating laryngeal mask in a patient with an uexpectedly large epiglottic cyst

Summary.

We report the successful use of the intubating laryngeal mask airway for rescue and intubation in an anaesthetised patient with an unexpectedly large epiglottic cyst. This case illustrates that airway rescue and intubation with the intubating laryngeal mask is possible and preoperative airway assessment does not always provide reliable information about airway management.

Key words:

Equipment: intubating laryngeal mask - Pathology: epiglottis

References

• 1 Brain A IJ, Verghese C, Addy E V, Kapila A. The intubating laryngeal mask. I: development of a new device for intubation of the trachea.  Br. J. Anaesth.. 1997;  79 699-703
• 2 Langenstein E, Moller F. [The importance of the laryngeal mask in the difficult intubation and early experience with the intubating laryngeal mask airway - ILMA-Fastrach].  Anaesthesiologie Intensivmedizin Notfallmedizin Schmerztherapie. 1998;  33 771-780
• 3 Brimacombe J. Difficult airway management with the intubating laryngeal mask.  Anesth. Analg.. 1997;  85 1173-1175
• 4 Brain A IJ, Verghese C, Addy E V, Kapila A, Brimacombe J. The intubating laryngeal mask. II: a preliminary clinical report of a new means of intubating the trachea.  Br. J. Anaesth.. 1997;  79 704-709
• 5 Cros A M, Colombani S. Preliminary study of intubation with a new laryngeal mask for difficult intubation.  Anesthesiology. 1997;  86 A482(Abstract)
• 6 Ferson D Z, Supkis D E, Rahlfs T F, Jones J L. Evaluation of the intubating laryngeal mask as a primary airway device and a guide for blind endotracheal intubation.  Anesthesiology. 1997;  87 A485(Abstract)
• 7 Joo H, Rose K. Fastrach - a new intubating laryngeal mask airway: successful use in patients with difficult airways.  Can. J. Anaesth.. 1998;  45 253-256
• 8 Parr M JA, Gregory M, Baskett P JF. The intubating laryngeal mask. Use in failed and difficult intubation.  Anaesthesia. 1998;  53 343-348
• 9 Joo H S, Rose D K. The intubating laryngeal mask airway with and without fiberoptic guidance.  Anesth. Analg.. 1999;  88 662-666
• 10 Baskett P JF, Parr M JA, Nolan J P. The intubating laryngeal mask. Results of a multicentre trial with experience of 500 cases.  Anaesthesia. 1998;  53 1174-1179
• 11 Brimacombe J, Brain A IJ, Berry A. The laryngeal mask airway: review and practical guide. London: WB Saunders Company Limited 1997
• 12 Evans A. Difficulty in inserting a laryngeal mask airway.  Anaesthesia. 1995;  50 468-469
• 13 Eagle C CP. Airway obstruction due to a vallecular cyst.  Anaesth. Intens. Care. 1993;  21 886
• 14 Verghese C, Rangasami J, Kapila A, Parke T. Airway control during percutaneous dilatational tracheostomy: pilot study with the intubating laryngeal mask airway.  Br. J. Anaesth.. 1998;  81 608-609
• 15 Kihara S, Watanabe S, Taguchi N, Suga A, Brimacombe J. A comparison of blind and lightwand-guided tracheal intubation through the intubating laryngeal mask.  Anaesthesia. 2000;  55 427-431
• 16 Brimacombe J, Keller C, Gunkel A R, Puehringer F. The influence of the tonsillar gag on efficacy of seal, anatomic position, airway patency and airway protection with the flexible laryngeal mask airway: A randomized, crossover study of fresh, adult cadavers.  Anesth. Analg.. 1999;  89 181-186