The modified laryngeal mask airway: four head and neck procedures in two children with mild subglottic stenosis.

The laryngeal mask airway (LMA) was first described in 1983, and has since been used for administration of general anesthesia, resuscitation and as an aid to bronchoscopy or intubation. When used for anesthesia, the LMA has the advantage of lessening potential subglottic injury as compared to an endotracheal tube. Children with mild subglottic stenosis often have minimal symptoms of airway compromise at baseline. However, a minor degree of subglottic irritation may result in dyspnea (as in upper airway infection or following laryngeal intubation). We have begun using the LMA in such patients undergoing a general anesthetic for head and neck procedures unrelated to the airway. The present report describes two such children who underwent rhinologic and ophthalmologic surgery using the LMA. No perioperative stridor or respiratory distress was noted, and the LMA did not interfere with the procedure. In addition, we describe a modification of the standard LMA to further facilitate surgical access to the head and neck.