LARYNGEAL MASK AIRWAY IN SEVERE CERVICAL ANKYLOSIS

Purpose: We present a case of the successful use of a laryngeal airway (LMA) to ventilate the lungs of a patient with severe ankylosing spon dylitis for surgery requiring intense muscular relaxation.; The use of an LMA in such circumstances is controversial, Clinical features: The patient was a 61-yr-old man with severe emphysema, a cervical spine f ixed in marked anterior flexion, and reduced mouth opening (35 mm). Th e patient refused an awake tracheal intubation because of a previous d istressing experience with a fibreoptic awake nasal intubation and an 11 day SICU stay with controlled ventilation via an endotracheal tube. Attempts at spinal blocks had failed in the past. After administratio n of thiopentone and succinylcholine a #4 LMA was inserted and the:lun gs were safely ventilated for a 10 min reduction of a dislocated femor al head. Conclusion: The present view that severe ankylosing spondylit is is a contraindication td the use of an LMA may need revision in vie w of this and other reports of successful airway management in patient s with that disease.