Laryngeal mask airway and high-frequency jet ventilation for the resectionof a high-grade upper tracheal stenosis

The surgical resection of a high-grade tracheal stenosis presents a special case of a difficult airway. A 20-year-old male was treated for a 45-mm lon g tracheal stenosis with 60% reduction of the patent airway area beginning 25 mm below the glottis. To avoid manipulations of the affected segment bef ore surgical exposure of the trachea was established, strictly supraglottic ventilation via a laryngeal mash airway was performed. During removal of t he stenosis and creation of the anastomosis, transglottic high-frequency je t ventilation (HFJV) is a convenient technique that enables optimal access to the operation field. Changing from HFJV to conventional ventilation afte r completion of the anastomosis is not necessary, and the jet catheter can be left in place until the end of the anesthesia. (C) 2001 by Elsevier Scie nce Inc.