Laryngeal Mask Airway insertion with total intravenous anesthesia for transsternal thymectomy in patients with myasthenia gravis: report of 5 cases

A novel combination of the Arndt endobronchial blocker and the laryngeal mask airway ProSeal™ provides one-lung ventilation for thoracic surgery

“…The laryngeal mask airway (LMA) is considered to be an extremely useful alternative to the endotracheal tube (ETT) in a number of clinical scenarios. Compared with conventional ETTs, the LMA causes less airway resistance, a decreased bronchoconstrictive reflex, less atelectasis and fewer pulmonary infections ( 1 ). However, the application of the LMA in thoracic anesthesia has been limited due to the requirement of one-lung ventilation (OLV), which appeared impossible for the LMA.…”

Use of ProSeal ® LMA and thoracic epidural in myasthenia patients for trans-sternal thymectomy: A case series

“…The ProSeal ® LMA is a major advance over the classic LMA because of the following reasons: It allows ventilation at much higher airway pressures; it protects the lungs from aspiration, the stomach from gastric insufflation and it facilitates passage of a gastric tube. [ 7 ] There are similar successful case reports using ProSeal ® LMA,[ 8 9 ] but our technique remains unique in employing a thoracic epidural for optimising the analgesic requirement and early extubation.…”

Laryngeal mask airway for transsternal thymectomy in myasthenic patients

“…[ 1 ] The authors mention that ‘ProSeal ® LMA’ has major advantage over the classic LMA and state, referring to our publication, that ‘…there are similar successful case reports using ProSeal ® LMA, but our technique remains unique….’ However, our case series consisted of use of classic LMA for transsternal thymectomy in patients with myasthenia gravis. The authors mention the disadvantages of the classic LMA use for transsternal thymectomy in patients with myasthenia gravis, then mention the advantages of ProSeal ® LMA, citing our article,[ 2 ] and said that these results support the superiority of the authors' novel technique. This appears to be a misinterpretation of what we attempted to convey through our article because we used only classic LMA in our patients.…”

“…[ 1 ] We are pleased that our case series on LMA use for transsternal thymectomy in patients with myasthenia gravis was cited. [ 2 ]…”

“…This appears to be a misinterpretation of what we attempted to convey through our article because we used only classic LMA in our patients. [ 2 ]…”