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Case Use of a ProSeal TM laryngeal mask airway and a Ravussin cricothyroidotomy needle in the management of laryngeal and subglottic stenosis causing upper airway obstruction

We report the successful use of a ProSeal TM laryngeal mask airway (PLMA) as a dedicated airway to allow ﬁbre-optic inspection and passage through a tightly stenosed glottic and subglottic lesion, before ﬁbre-optic-guided transtracheal placement of a Ravussin needle and jet ventilation. The described technique avoided both tracheostomy and the potential of ‘seeding’ the tumour by passage of the needle through the mass. The PLMA may be a useful ‘dedicated airway’ and has several advantages over the classic LMA (cid:1) z and intubating LMA when used for this purpose. These include improved airway seal and reduced risk of aspiration. Four other cases of use of the PLMA as a dedicated airway during management of difﬁcult airways are discussed. Br 2005; :