The laryngeal mask in pediatric adenotonsillectomy. A dangerous toy or a medical advance?

Anaesthesia both for adenotomy (AT) and for tonsillectomy (TE) frequently p resents a challenge. On one hand, children scheduled for adenotomy often ha ve upper airway infections and are thus at risk of laryngo- and bronchospas m; on the other hand the ENT surgeon and the anaesthetist have to share the "workspace" in the patient's mouth. Since the succinyl choline debate in t he early 1990s, the question of the best muscle relaxant has gone hand in h and with that of the most appropriate means of securing the airway. The con cept of the laryngeal mask as airway was initially greeted with scepticism. Following several years' use of the mask for this purpose in AT and TE in young children, we report our experience and summarise the literature on th is topic. The laryngeal mask represents a safe alternative to intubation, p rovided there is close cooperation with the ENT surgeon.