[Clinical application of superimposed high-frequency jet ventilation in adult and pediatric laryngotracheal surgery].

Objective: To investigate the clinical application of superimposed high-frequency jet ventilation (SHFJV) in laryngotracheal surgery. Methods: A retrospective analysis was conducted on 158 cases undergoing SHFJV-assisted laryngotracheal surgery at West China Hospital of Sichuan University from January 2018 to June 2023. Among these cases, 122 were adults (50 females and 72 males) and 36 were children (8 females and 28 males). The patients had a mean age of 39.82±23.91 years, with the oldest patient being 83.5 years old and the youngest only 6 days old. The inclusion criteria encompassed laryngotracheal stenosis, space-occupying lesions, and functional disorders. The surgical and anesthetic processes were closely monitored. Data were collected for all patients, including general demographic information, diagnoses, surgical records, anesthetic data, complications, and the success rate of SHFJV. For two groups of continuous variables conforming to a normal distribution, the independent-samples t-test was used; for categorical variables, the chi-square test or Fisher's exact test was applied. All statistical analyses were performed using R 4.0.5 and SPSS 26.0 software. A P-value <0.05 was considered statistically significant. Results: The clinical application of SHFJV in laryngotracheal surgery was mainly concentrated in the following three scenarios: (1) Patients with difficult or impossible orotracheal intubation due to laryngeal or tracheal stenosis; (2) Patients in whom endotracheal intubation impaired the exposure of lesions; and (3) Patients in whom endotracheal intubation interfered with surgical manipulation. All patients maintained stable intraoperative vital signs without SHFJV-related complications. The overall ventilation success rate reached 98.7%, with only 2 critical cases requiring emergent tracheostomy due to progressive hypoxemia. There was no statistically significant difference in the success rate of SHFJV-supported surgery between the adult group and the pediatric group[99.2%(121/122) vs. 97.2%(35/36), χ2=0.69, P=0.405]. Conclusions: SHFJV, leveraging its dual-flow synergistic mechanism, safely facilitates complex laryngotracheal surgeries in both adults and children. This demonstrates marked advantages in managing stenosis, optimizing anatomical exposure, and ventilation management, thereby expanding technical options for tubeless laryngotracheal surgery.