Laryngeal mask combined with bronchial blocker provides an alternative for lung isolation but lacks adequate access to the non-dependent lung. Substituting the blocker with a bronchial tube may overcome this limitation. In this report, a #4.5 cuffed bronchial tube was introduced into the non-dependent lung through a second-generation laryngeal mask for transthoracic oesophagectomy. During the 2.5-hour thoracotomy, one-lung ventilation was achieved by isolating the left lung with the bronchial tube and ventilating the right lung via the laryngeal mask, using volume-control mode (7 mL/kg × 12/min) with PIP21–23 cm H2O, pH 7.36 and PaCO2 38.3. Prior to thoracotomy closure, suction and reinflation of the left lung were performed through the bronchial tube. Bronchoscopy via the laryngeal mask revealed no injury to the airway after removal of the bronchial tube. The case shows that laryngeal mask combined with bronchial intubation provides one-lung ventilation with access to the isolated lung.

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A flexible laryngeal mask airway device (LMAD) embedded with 2 pharyngeal suction catheters was used for a young female patient who underwent a revision rhinoplasty, septoplasty, and chin implant. The modified LMAD was constructed by attaching 2 suction catheters onto the back of the mask; it functioned well without signs of malfunction or complications, with a total of 71 mL of blood evacuated from the pharyngeal area during the five and a half hour surgery. The patient emerged from anesthesia without coughing or straining, and reported no sore throat or nausea/vomiting in the recovery room.