The difficult airway: The use of subglottic jet ventilation for laryngeal surgery

Laryngeal papillomatosis is a rare disease, caused by human papilloma virus infection. It can present with various respiratory signs and symptoms, including but not limited to hoarseness, respiratory distress, and stridor. Anesthetic management of this condition is challenging due to multiple factors such as shared airway with the ear, nose, and throat surgeon, potential difficult airway, and associated complications related to jet ventilation and/or laser use in the airway. The chapter discusses the most important and clinically relevant facts related to this condition. Topics covered include difficult airway, airway laser airway fire, jet ventilation, and barotrauma. A case study of a 55-year-old overweight male patient who presents to the operating room for an elective removal of his recurrent laryngeal papillomas is used as an example.

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Supraglottic Jet Ventilation Assists Intubation in a Patient with Difficult Airway Due to Unrecognizable Supraglottic Structures

Journal of Anesthesia & Clinical Research ◽

10.4172/2155-6148.1000141 ◽

2011 ◽

Vol 02 (06) ◽

Author(s):

J Andrew Dziewit ◽

Huafeng Wei

Keyword(s):

Difficult Airway ◽

Jet Ventilation

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Jet ventilation for laser laryngeal surgery in children. Modification of the saunders jet ventilation technique

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/0165-5876(87)90051-6 ◽

1987 ◽

Vol 14 (1) ◽

pp. 65-71 ◽

Cited By ~ 8

Author(s):

Lawrence M. Borland ◽

James S. Reilly

Keyword(s):

Jet Ventilation ◽

Laryngeal Surgery ◽

Ventilation Technique

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Cricothyroidotomy and Transtracheal High Frequency Jet Ventilation for Elective Laryngeal Surgery. An Audit of 90 Cases

Anaesthesia and Intensive Care ◽

10.1177/0310057x0002800112 ◽

2000 ◽

Vol 28 (1) ◽

pp. 62-67 ◽

Cited By ~ 26

Author(s):

W. C. Russell ◽

A. M. Maguire ◽

G. W. Jones

Keyword(s):

High Frequency ◽

Perioperative Complications ◽

Cricothyroid Membrane ◽

Jet Ventilation ◽

Intravenous Cannula ◽

High Frequency Jet Ventilation ◽

Laryngeal Surgery ◽

Endolaryngeal Surgery ◽

Surgical Emphysema ◽

Technical Details

We carried out an audit of needle cricothyroidotomy and transtracheal ventilation used during anaesthesia for elective endolaryngeal surgery. The data on 90 consecutive procedures was collected over two years. Patients were anaesthetized using a total intravenous technique. An intravenous cannula or Tuohy needle was placed through the cricothyroid membrane and the patient was ventilated via the cannula using high frequency jet ventilation. Technical details of the procedure and any perioperative complications were recorded. There were 12 complications in total. Only three of these were clearly related to the cricothyroid puncture, i.e., one minor bleed and two cases of limited local surgical emphysema. All complications were minor and resolved without sequelae.

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