[The airway management using laryngeal mask airway and tracheal fiberscopy in a pediatric patient with tracheal stenosis after tracheostomy].
A 9-year-old boy was scheduled for excision of tracheal granuloma which had developed at the tip of a tracheostomy tube. Instead of a tracheostomy tube, a 4 mm ID tracheal tube was inserted via the tracheostomy beyond the tracheal constriction because of rapid development of respiratory failure. General anesthesia was induced and maintained with sevoflurane and oxygen via the tube, and a size 2.5 laryngeal mask airway (LMA) was inserted without muscle relaxant. Spontaneous respiration remained. Under monitoring by fiberoptic tracheoscopy via the LMA, the tracheal tube was extubated carefully. An 8 Fr. suction tube was indwelled via the tracheostomy beyond the stenosis for oxygen supply. After sealing the tracheostomy, he could breath spontaneously through the LMA. During the excision of tracheal granuloma by holmium:YAG laser, fiberoptic observation was continued via the LMA, and the procedure was performed without any complication. We conclude that the tracheal stenosis can be managed using the LMA, continuous fiberoptic monitoring and additional option of keeping spontaneous ventilation.
Ogata
Junichi
J
Department of Anesthesiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu 807-8555.
Horishita
Takafumi
T
Minami
Kouichiro
K
D000768:Anesthesia, General; D002648:Child; D019723:Endoscopes; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D053685:Laser Therapy; D008297:Male; D012119:Respiration; D014135:Tracheal Stenosis / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D014139:Tracheostomy / Q000009:adverse effects