EMERGENCY USE OF THE LARYNGEAL MASK AIRWAY IN SEVERE UPPER OBSTRUCTION CAUSED BY SUPRAGLOTTIC EDEMA

We report two cases of severe upper airway obstruction caused by supra glottic oedema which developed rapidly at the time of anaesthesia. Con ventional methods to relieve the obstruction failed and it was only ov ercome when a laryngeal mask airway (LMA) was inserted and positive pr essure applied manually during inspiration. In one case a fibrescope w as passed via the LMA and this revealed two cushions of oedematous fal se vocal cords protruding into the bowl of the LMA which were pushed o ut of the way when positive pressure was applied during inspiration. W e believe that the LMA should be considered in the emergency managemen t of severe upper airway obstruction even when this involves supraglot tic oedema.