The Laryngeal Mask in the Management of a Paediatric Difficult Airway

The difficult paediatric airway: a new method of intubation using the laryngeal mask airway™, Cook® airway exchange catheter and tracheal intubation fibrescope

“…The LMA has an established role in the management of the difficult adult airway. Its use in the difficult paediatric airway is less well documented, but the LMA is increasingly used to secure the airway and to act as an aid to tracheal intubation (1–13).…”

“…A number of previous case reports have highlighted the role of the laryngeal mask airway (LMA™) in the management of the difficult paediatric airway (1–6). Although the LMA allows a patent airway to be maintained in the majority of cases, there is still a need for tracheal intubation in certain circumstances.…”

Blind Nasal Intubation by Monitoring Capnography in a Neonate with Congenital Microstomia

“…Reported anaesthetic management of paediatric microstomia has often included the use of ketamine'•5 with various methods of airway control. Successful airway maintenance has been achieved with a nasopharyngeal airway alone' or more recently the use of the laryngeal mask 6 • Direct visualisation of the larynx often proves impossible although the use of a rigid tubular oral pharyngolaryngoscope has proved successful' .…”

The Management of difficult intubation in children

“…The classic laryngeal mask airway (cLMA) was used on a group of 34 children with craniofacial and mucopolysaccharide disorders and the airway was either classed as good or adequate in all patients. In no patients did the LMA provide a poor airway (26). This data compares with normal patients who had a clear airway in 98% (31).…”

“…In addition, the fiberoptic view was either full or partial in 54% with the rest having a view of the epiglottis within the lumen of the LMA. The laryngeal structures of all patients with some manipulation of the fiberscope could be visualized and therefore intubated fiberoptically if needed (26). This data in addition to the many case reports of the use of the cLMA in pediatric anesthetic practice make the cLMA essential to the safe management of the difficult pediatric airway.…”