title: Hunsaker Mon-Jet tube ventilation: a 15-year experience.
abstract: OBJECTIVE
  The Hunsaker Mon-Jet tube (HMJT) (Xomed, Jacksonville, FL) has been used effectively for subglottic ventilation. We previously reported a series of 552 patients over a 10-year period with no major complications. This is a continuation of that series with an additional 5 years of cases.
  
  
  METHODS
  Retrospective consecutive case series.
  
  
  METHODS
  Patients who were ventilated with the HMJT for microlaryngeal surgery at the University of Washington Medical Center over a 15-year period (1995-2010) were identified from the Voice Disorders database. Charts were reviewed for demographic data, laryngeal diagnosis, and anesthetic parameters. Main outcome measure was the rate of complications.
  
  
  RESULTS
  Fifty-seven complications occurred in 49 cases out of 839 cases (5.8% complication rate). In descending order, the complications were hypoxia (SpO(2) <90%, n = 30, 3.6%), hypercarbia (end tidal CO(2) of >60 mm Hg, n = 17, 2.0%), airway obstruction (n = 4, 0.5%), barotrauma (n = 2, 0.2%), seeding of blood into trachea (n = 2, 0.2%), submucosal injection of air (n = 1, 0.1%), and mucosal damage (n = 1, 0.1%). Factors associated with complications included high body mass index (P = .04), American Society of Anesthesiology class III or IV (P = .01), history of heart disease (P = .02), history of previous laryngeal surgery (P = .02), longer duration of case (P = .006), and laser use (P = .005).
  
  
  CONCLUSIONS
  Although subglottic ventilation via an HMJT is a safe alternative to traditional endotracheal intubation in an appropriately selected population, practitioners should remain vigilant about the known complications.
authors.affiliation: Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Washington Medical Center, Seattle, Washington 98195, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Hu
authors.forename: Philip A
authors.initials: PA
authors.lastname: Weissbrod
authors.forename: Nicole C
authors.initials: NC
authors.lastname: Maronian
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hsia
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Davies
authors.forename: Gouri K
authors.initials: GK
authors.lastname: Sivarajan
authors.forename: Allen D
authors.initials: AD
authors.lastname: Hillel
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D001469:Barotrauma / Q000453:epidemiology / Q000209:etiology; D015984:Causality; D015897:Comorbidity; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000453:epidemiology; D006611:High-Frequency Jet Ventilation / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D000860:Hypoxia / Q000453:epidemiology / Q000209:etiology; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D007828:Laryngoscopy; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D009767:Obesity, Morbid / Q000453:epidemiology; D011127:Polyps / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors