JUVENILE LARYNGEAL PAPILLOMATOSIS - SCARY ANESTHETIC

We describe three children ages 20 to 33 months who presented for surg ical resection of their laryngeal papillomata. Their anaesthetic manag ement revealed the severity of obstruction which these children presen ted and the obstacles that faced the anaesthesiologist trying to secur e the airway and provide adequate ventilation. The airway obstruction had both a fixed and a dynamic component to it. This was evidenced by the ability of the children to maintain ventilation when spontaneously breathing. But, they exhibited total obstruction when ventilation was attempted via mask using positive pressure. It is possible to encount er obstruction to ventilation after the trachea has been intubated bec ause of papillomata that were 'shaved off,' filling the tracheal tube lumen.