Orotracheal intubation through the laryngeal mask airway in paediatric patients with Treacher‐Collins syndrome

Abstract

The laryngeal mask airway (LMA) is useful as an airway intubator (conduit) for an intubating tracheal bougie or fibreoptic bronchoscope, over which a tracheal tube is passed. However, in our paediatric patients with Treacher-Collins syndrome, only the latter technique was successful. This was attributed to the fact that a posteriorly protruded tongue displaced the LMA, made the glottis move considerably anterior and interfered with the attempts to enter the trachea with a bougie. Downward displacement of the epiglottis, which can sometimes impair the intubation technique through the LMA, was not observed in our patients. Partial obstruction of a tracheal tube within the LMA occurred in one of the patients.

The airway approach to a neonate with Treacher Collins syndrome – Case report

“…It is well described in the literature that reduces and deforms the oral cavity and the posterior protrusion of the tongue due to mandibular hipoplasia. 1,6 The decision on using these two devices before step in FFB was based on our technical skills when comparing the different equipment at our disposal. Besides that, there are successful cases describing the use of Frova ® and/or Airtraq ® .…”

The difficult paediatric airway: a new method of intubation using the laryngeal mask airway™, Cook® airway exchange catheter and tracheal intubation fibrescope

“…The LMA has an established role in the management of the difficult adult airway. Its use in the difficult paediatric airway is less well documented, but the LMA is increasingly used to secure the airway and to act as an aid to tracheal intubation (1–13).…”

“…Although the LMA allows a patent airway to be maintained in the majority of cases, there is still a need for tracheal intubation in certain circumstances. The use of the LMA as an aid to intubation in paediatric patients has been described by several authors (7–13). The LMA has also been used in conjunction with airway exchange catheters to facilitate guided intubation of the trachea with mixed results (14,15).…”

Use of intubation introducers through a supraglottic airway to facilitate tracheal intubation: a brief review

“…Most occurrences are documented in case reports/series rather than in clinical trials. [45][46][47][48][49][50][51][52] In children, the conduit most often used for tracheal intubation is the LMA Classic TM or the LMA Unique TM . The main modalities to access the pediatric trachea with use of a bronchoscope are: 1) use of a traditional ETT directly via the SGA, 2) use of an airway exchange catheter over a bronchoscope, and 3) use of a guidewire through the working channel of the bronchoscope.…”