title: [High-frequency jet ventilation in otorhinolaryngology - surgical and anaesthesiologic issues].
abstract: BACKGROUND
  High-frequency jet ventilation (HFJV) through thin catheters creates more room for surgical procedures in laryngotracheal surgery, while few contraindications exist. In contrast, the anaesthesiologist has to cope with reduced monitoring and numerous contraindications. Therefore, every participating discipline has to thoroughly know the method. We report our experiences with HFJV and focus on relevant points, which contribute to a safe and cooperative procedure.
  
  
  METHODS
  We performed a retrospective chart review for patients, who were operated for benign laryngotracheal lesions using HFJV at the Hannover Medical School, Department of Otorhino-Laryngology between June 2012 and February 2013. We analyze patient characteristics, complications and important anaesthesiologic and operative steps.
  
  
  RESULTS
  A total of 46 cases of microlaryngoscopies and tracheoscopies were included in this study. The median body mass index was 27 kg/m(2). According to the ASA-classification, 24% of patients were categorized class I, 54% class II and 22% class III. In 2 cases we had reversible, peripheral desaturations down to 70%. In one case, emergent re-intubation with an endotracheal tube was inevitable due to rapid desaturation below 50%. Further complications were not observed.
  
  
  CONCLUSIONS
  HFJV represents a safe ventilation approach in laryngotracheal surgery, when patients are thoroughly selected. Especially the surgeon benefits from more room in the operating field. Obesity, reflux and cardiopulmonary diseases have to be evaluated well, as these can represent relative contraindications. Individual decisions can be made under consideration of all comorbidities.
authors.affiliation: Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Hochschule Hannover, Hannover.
authors.forename: V
authors.initials: V
authors.lastname: Helmstaedter
authors.affiliation: Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover.
authors.forename: R
authors.initials: R
authors.lastname: Tellkamp
authors.affiliation: Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Hochschule Hannover, Hannover.
authors.forename: B
authors.initials: B
authors.lastname: Schwab
authors.affiliation: Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Hochschule Hannover, Hannover.
authors.forename: T
authors.initials: T
authors.lastname: Lenarz
authors.affiliation: Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Hochschule Hannover, Hannover.
authors.forename: M
authors.initials: M
authors.lastname: Durisin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D004724:Endoscopy / Q000295:instrumentation; D004867:Equipment Design; D006611:High-Frequency Jet Ventilation / Q000295:instrumentation; D006801:Humans; D007223:Infant; D007828:Laryngoscopy / Q000295:instrumentation; D008297:Male; D008866:Microsurgery / Q000295:instrumentation; D008875:Middle Aged; D010038:Otorhinolaryngologic Diseases / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000295:instrumentation; D061214:Patient Safety; D018579:Patient Selection; D012189:Retrospective Studies; D014132:Trachea / Q000601:surgery; D055815:Young Adult