The laryngeal mask airway and otorhinolaryngology head and neck surgery

Summary: Ranieri Jr D, Neubauer AG, Ranieri DM, Nascimento Jr P -The Use of Disposable Laryngeal Mask Airway for Adenotonsillectomies. Background and objectives:Tracheal intubation associated with airway operations can cause complications such as laryngospasm, bronchospasm and periods of reduced oxygen saturation. Such complications are frequently reported during adenotonsillectomies, a procedure that by nature increases the incidence of airway complications. The objective of this study was to compare the occurrence of respiratory problems during adenotonsillectomies while using either a disposable laryngeal mask airway (LMA) or an endotracheal tube (TT).

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“…However, some authors have suggested that there is a lower complication rate with laryngeal mask airways 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Uso da máscara laríngea descartável em adenotonsilectomias

Ranieri

Neubauer

Ranieri³

et al. 2012

Rev. Bras. Anestesiol.

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“…LMA usage is not very popular in neck surgery, due to the possibility of displacement after neck extension and surgical manipulations of the trachea, as well as the inconvenience caused by limited access to the airway if adjustments of LMA position are needed during surgery [16]. ETT usage remains the typical practice for major neck surgeries [10]. However, LMA, in combination with a fiberoptic bronchoscope, has been successfully used for intraoperative monitoring of recurrent laryngeal [23–30] and superior laryngeal [31] nerve function.…”

Section: Discussionmentioning

confidence: 99%

“…Laryngeal mask airway (LMA) is currently used as an alternative for airway management during thyroidectomy [10–12]. The Protector™ (Teleflex Medical Europe Ltd., Westmeath, Ireland) LMA is a second‐generation supraglottic airway device (SAD) with a built‐in cuff pressure indicator, which ensures filling of the air chamber of the mask with the appropriate volume of air.…”

Section: Introductionmentioning

confidence: 99%

Comparison Between the Protector™ Laryngeal Mask Airway and the Endotracheal Tube for Minimally Invasive Thyroid and Parathyroid Surgery

et al. 2019

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Background Pharyngolaryngeal symptoms are a main concern after neck surgery. The Protector TM LMA is a new supraglottic airway device. The main purpose of this study was to evaluate whether application of the LMA Protector TM causes fewer pharyngolaryngeal symptoms than application of the endotracheal tube after minimally invasive total thyroidectomy and parathyroidectomy. Methods This prospective, randomized controlled trial involved one university and one private practice clinic, during the period from January 2017 until November 2017. The patients were randomly allocated to two groups: ETT and LMA. Main outcomes were Numerical Rating Scale scores of postoperative dysphagia, pharyngodynia, and incisional pain. Secondary outcomes were the frequency of rescue analgesia (paracetamol) consumption and emergence cough. Data were recorded in the post-anesthesia care unit and at 1, 6, 12, and 24 h after surgery. Results Data from 78 patients were included in the final analysis. Pharyngodynia scores were significantly lower in the LMA group, compared with the ETT group, at 1 h, 6 h and 12 h after surgery. Dysphagia and surgical incision pain scores were also significantly lower in the LMA group, compared with the ETT group, at 6 h and 12 h after surgery. The frequency of postoperative paracetamol consumption was significantly increased in the ETT group, compared with the LMA group. Finally, the LMA group had fewer episodes of emergence cough, compared with the ETT group. Conclusion The LMA Protector TM causes fewer pharyngolaryngeal symptoms than the ETT within 6 and 12 h after minimally invasive total thyroidectomy and parathyroidectomy. Trial registration ClinicalTrials.gov Identifier NCT03098667.

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“…The laryngeal mask airway (LMA), which allows the maintenance of upper airway patency without the need for direct visualization of the vocal cords and could avoid potential trauma during the tracheal intubation process, is an alternative to ETT 10 that is gaining popularity in head and neck surgery in the last two decades 11 – 14 . The potential beneficial impacts of using LMA on minimizing potential damage to the vocal cords and preventing postoperative pharyngolaryngeal symptoms 15 have been supported by the results of previous studies showing a significant reduction in the incidences of postoperative hoarseness and sore throat in patients using LMA compared to those receiving ETT for general anesthesia 16 , 17 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of laryngeal mask airway against postoperative pharyngolaryngeal complications following thyroid surgery: a systematic review and meta-analysis of randomized controlled studies

Hung

Hsu

et al. 2022

Sci Rep

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This meta-analysis aimed at investigating the effectiveness of laryngeal mask airway (LMA) against postoperative pharyngolaryngeal complications after thyroidectomy. MEDLINE, Cochrane Library, google scholar, and EMBASE databases were searched from inception through February, 2021, for randomized controlled trials (RCTs) comparing the incidence of pharyngolaryngeal complications following the use of LMA or endotracheal tube (ETT). Pooled results from seven RCTs involving 600 patients showed an association of LMA with a reduced risk of postoperative sore throat (POST) at 24 h [risk ratio (RR) 0.75, p = 0.006, four trials], but not at 1 h and 48 h after thyroidectomy. POST severity and hoarseness risk were lower in the LMA group than the ETT group at 1 h, 24 h, and 48 h (all p < 0.05). Nevertheless, hoarseness severity was lower in the LMA group only at postsurgical 48 h [standardized mean difference = − 0.35, p = 0.008, three trials]. Moreover, the risk of emergence cough was lower in patients using LMA than those receiving ETT (RR = 0.14, p = 0.002, two trials). The two groups did not differ in the severity of dysphagia at postoperative 1 h, 24 h, and 48 h. This meta-analysis showed that LMA may be associated with fewer pharyngolaryngeal complications compared to ETT without airway impacts. The limited number of included studies warrants further research to support our findings.

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The laryngeal mask airway and otorhinolaryngology head and neck surgery

Cited by 9 publications

References 48 publications

Uso da máscara laríngea descartável em adenotonsilectomias

Uso da máscara laríngea descartável em adenotonsilectomias

Comparison Between the Protector™ Laryngeal Mask Airway and the Endotracheal Tube for Minimally Invasive Thyroid and Parathyroid Surgery

Efficacy of laryngeal mask airway against postoperative pharyngolaryngeal complications following thyroid surgery: a systematic review and meta-analysis of randomized controlled studies

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