Table 3:
Previous published studies and case reports on laryngeal mask airway use in tracheal resection and reconstruction
| Author and year of publication | Study type | Number of patients | Type of stenosis | Type of LMA | Ventilation strategy | Main results |
|---|---|---|---|---|---|---|
| Menna and Fiorelli et al., 2021 |
Single-centre retrospective study Case–control matching analysis with 1:1 ratio |
n = 184 n = 22 patients managed through LMA (LMA group) matched with n = 22 patients managed through ETT (ETT group) |
Laryngotracheal stenosis and tracheal stenosis | i-gel | PPV |
LMA provided sufficient ventilation in all patients. Operative time was shorter in patients with LMA. ICU admission rate and stay were lower in the LMA group. Dysphonia was more frequent in ETT group than in LMA group. |
| Schweiger et al. [15], 2020 | Single-centre retrospective study | n = 108 | Laryngotracheal stenosis | Classical LMA | PPV and HFJV in complex subglottic resections or laryngotracheal reconstructions |
Sufficient ventilation using a laryngeal mask was possible in 107 of 108 patients (99.1%). In 1 patient with severe retrognathism, correct positioning of the LMA was not feasible. Postoperatively, 2 patients (1.9%) developed pneumonia. |
| Krecmerova et al. [17], 2017 | Single-centre retrospective study | n = 54 | Tracheal stenosis | Laryngeal mask LarySeal | VCV |
LMA was successfully inserted in 53 (98.1%) patients. One patient developed dislocation, and repositioning was not feasible due to anatomical changes caused by radiotherapy and prior surgical resections. |
| Schieren et al. [8], 2017 | Single-centre retrospective study | n = 10 | Laryngotracheal stenosis and tracheal stenosis | Classical LMA | PPV and HFJV |
LMA insertion and subsequent PPV were successful in all patients. One patient with preoperative respiratory failure had persistent hypercarbia. Six patients (60%) had an uneventful postoperative course. Postoperative complications (i.e. vocal cord oedema, postoperative haemorrhage, pneumonia) occurred in 4 patients (40%). |
| Zardo et al. [23], 2016 | Case report | n = 1 | Laryngotracheal stenosis | Classical LMA | PPV | Unexpected higher stenosis and conventional intubation were impossible. |
| Caronia et al. [20], 2016 | Case report | n = 1 | Tracheal stenosis | Classical LMA | Spontaneous breathing | Successful management without complications. |
| Donaldson et al. [19], 2010 | Case report | n = 1 | Laryngotracheal stenosis | i-gel | VCV | i-gel supraglottic airway was inserted without difficulty, provided a good seal and allowed for controlled ventilation with acceptable peak pressures throughout the operation. |
| Biro et al. [7], 2001 | Case report | n = 1 | Tracheal stenosis | Classical LMA | PPV and HFJV | Successful management without complications. |
| Adelsmayr et al. [10], 1998 | Case report | n = 1 | High tracheal stenosis | Classical LMA | PPV and HFJV |
Peak airway pressure was limited to 15 cm H2O. End-tidal CO2 in the normal range (33-40 mmHg). |
| Asai et al. [22], 1993 | Case report | n = 1 | Tracheal stenosis | Classical LMA | Spontaneous breathing | End-expiratory carbon dioxide tension and arterial oxygen saturation were within normal limits. |
| Asai et al. [21], 1991 | Case report | n = 1 | Laryngotracheal congenital stenosis | Classical LMA | PPV | Increase of airway pressure and hypercarbia during surgery. |
ETT: endotracheal intubation; HFJV: high-frequency jet ventilation; ICU: intensive care unit; LMA: laryngeal mask airway; PPV: positive pressure ventilation; VCV: volume-controlled ventilation.