NASAL FIBEROPTIC TRACHEAL INTUBATION IN ANESTHETIZED PATIENTS BREATHING VIA A MODIFIED LARYNGEAL MASK AIRWAY

A modified laryngeal mask airway was used to facilitate nasotracheal i ntubation with a fibreoptic laryngoscope. A size 4 laryngeal mask airw ay was modified by creating a defect at the base of the stem and remov ing the bars to allow passage of the fibreoptic laryngoscope from the nasopharynx to the larynx. The laryngeal mask airway cuff was split an d the cut edges were sealed with silicone. This design allowed the cuf f to function normally and allowed removal of the split laryngeal mask airway after the tracheal cube had been 'railroaded' into place. Thir ty-four patients were studied. The split laryngeal mask airway was eas ily inserted with satisfactory airway maintenance in 32 patients. Nasa l airway endoscopy and laryngoscopy were successfully achieved with th e split laryngeal mask airway in place in 31 of 32 patients. Railroadi ng the tracheal tube over the fibreoptic laryngoscope with the split l aryngeal mask airway in place was successful in all 31 of these patien ts. This prototype split laryngeal mask airway allows good airway main tenance while fibreoptic nasotracheal intubation is performed.