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Neonatal and paediatric fibre-optic laryngoscopy and bronchoscopy using the laryngeal mask airway

Published online by Cambridge University Press:  29 June 2007

A. E. Hinton ,
J. M. O'Connell ,
J. P. Van Besouw  and
M. E. Wyatt
A. E. Hinton*
Affiliation:
Department of Otolaryngology, St George's Hospital, London, UK.
J. M. O'Connell
Affiliation:
Department of Otolaryngology, St George's Hospital, London, UK.
J. P. Van Besouw
Affiliation:
Department of Anaesthesia, St George's Hospital, London, UK.
M. E. Wyatt
Affiliation:
Department of Otolaryngology, St George's Hospital, London, UK.
*
Address for correspondence: A. Hinton, F.R.C.S., Department of Otolaryngology, St George's Hospital, London SW17 0QT. Fax: 0181 725 3306
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Abstract

Endoscopy of the upper airways in neonates and infants has traditionally been accomplished using rigid laryngoscopes and bronchoscopes. The laryngeal mask may be used both to control the airway for anaesthetic ventilation and to guide a fibre-optic endoscope to the laryngeal inlet and beyond.

We report our experience with five neonatal and paediatric cases where fibre-optic laryngoscopy and bronchoscopy were performed through the laryngeal mask airway. All were cases in which standard rigid endoscopy had proved difficult with only a poor and restricted view of the laryngeal inlet being obtained due to the age of the infants, or abnormal anatomy of the upper airways.

No problems have been encountered with maintenance of the airway or with the endoscopic view obtained. In fact in neonatal patients, this technique has been found to be preferable with regard to safety and ease of use when compared to the ventilating bronchoscope. With the size 1 laryngeal mask airway it is not possible to simultaneously ventilate and endoscope the patient. Cases included, a vascular ring, Goldenhar's syndrome, laryngomalacia, supraglottis and vocal fold paresis.

This technique provides a secure method of maintaining anaesthetic ventilation during airway endoscopy, and also a means of easily locating the glottis.

Keywords

LaryngoscopyBronchoscopyInfant
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 4 , April 1997 , pp. 349 - 353
Copyright
Copyright © JLO (1984) Limited 1997

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