Airway management and anesthesia in neonates, infants and children during endolaryngotracheal surgery

Abstract

Supraglottic superimposed high-/low-frequency jet ventilation via jet laryngoscopes with integrated jet nozzles is a minimally invasive ventilation technique for neonates, infants and children in endolaryngotracheal surgery, which allows an unimpaired operating field for the surgeon especially in LASER surgery.

Successful use of C-MAC® video laryngoscope following failure of multiple intubation attempts during laryngomicroscopic surgery in an infant - A case report -

“…There are several specific ventilation techniques associated with LMS, such as transtracheal jet ventilation, high frequency oscillatory ventilation, and intermittent ventilation with a microlaryngoscopy tube [11,12]. However, in the present case, a jet ventilator or microlaryngoscopy tube was not available and the tracheal tube needed to be removed for tracheal bougienage.…”

Anesthesia management in pediatric patients with laryngeal papillomatosis undergoing suspension laryngoscopic surgery and a review of the literature

“…Additionally, the insertion of a catheter stimulates the occurrence of endotracheal granulation, tracheal stenosis, and tracheal obstruction. Performing a tracheotomy can also easily cause subcutaneous emphysema, pneumomediastinum or tracheoesophageal fistulas, choking, coughing, and wound infections [14]. Meanwhile, the incision site for the tracheotomy may cause the formation of a junctional zone and promote the growth of papillomas around the stoma and in the trachea [15].…”

Technical description of a modified jet ventilation injector for airway laser surgery in neonates and infants: retrospective analysis of 20 cases

“…The third is standard ventilation with a laser-compatible endotracheal tube, but it limits the surgeon's vision of the larynx. Moreover, tube size for small infants remains an issue [2,3]. Last, jet ventilation (JV) provides excellent surgical conditions but is not commonly used in infants.…”

“…The second is apneic anesthesia/ventilation with intermittent ventilation and oxygenation, which gives the surgeon only short periods of access to the larynx and carries a risk of hypoxemia because infants have higher O 2 consumption. In addition, unless mask ventilation is provided in between the periods of apnea, this technique exposes the patient to multiple intubations/ extubations with their own risks [3,4]. The third is standard ventilation with a laser-compatible endotracheal tube, but it limits the surgeon's vision of the larynx.…”