Blockbuster Laryngeal Mask Airway as a Rescue Device in Paediatric Patient with Retrognathia Posted for Microtia Reconstruction Surgery: A Case Report
Madhu, Monika, Roopa, Himadri Chanda, Nitu Yadav
1. Senior Resident, Department of Anaesthesia, Pt BDS PGIMS, Rohtak, Haryana, India.
2. Senior Resident, Department of Anaesthesia, Pt BDS PGIMS, Rohtak, Haryana, India.
3. Junior Resident, Department of Anaesthesia, Pt BDS PGIMS, Rohtak, Haryana, India.
4. Junior Resident, Department of Anaesthesia, Pt BDS PGIMS, Rohtak, Haryana, India.
5. Assistant Professor, Department of Anaesthesia, Pt BDS PGIMS, Rohtak, Haryana, India.
Correspondence Address :
Dr. Madhu,
C66, Sector 35, Suncity, Rohtak-124001, Haryana, India.
E-mail: madhuahlawat27@gmail.com
Abstract
The first and second branchial arches, along with the first branchial cleft, contribute to the development of ear and mandible. Children with microtia can have retrognathia or micrognathia and have challenging airway management. Managing the airway in these patients presents a significant challenge for anaesthesiologists as they have the potential for upper airway obstruction and challenging tracheal intubation because of facial deformities. Although awake fiberoptic intubation is a well-accepted method for handling difficult intubations, it can be uncomfortable and stressful for paediatric patients. Moreover, it demands expertise and is unsuitable for patients unwilling to undergo awake intubation. This case report highlights the use of the blockbuster Laryngeal Mask Airway (LMA) in an 11-year-old retrognathic child with microtia with anterior larynx scheduled for auricular reconstruction surgery. There was a failure to secure the airway with multiple attempts at traditional intubation and the supraglottic airway device i-gel, as the child had an anterior larynx and Cormack Lehane (CL) grading of 4 on direct laryngoscopy. The blockbuster LMA, distinguished by its innovative design facilitating both ventilation and intubation through an integrated channel, emerged as a pivotal alternative. The supraglottic device is not the technique of choice, but it can definitely be an alternative and could be life-saving in situations where fiberoptic bronchoscopy and tracheostomy are not available.
Keywords
Anaesthetic challenges, Difficult airway, Supraglottic airway devices
DOI and Others
DOI: 10.7860/JCDR/2024/69751.19235
Date of Submission: Jan 28, 2024
Date of Peer Review: Feb 12, 2024
Date of Acceptance: Feb 24, 2024
Date of Publishing: Apr 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jan 28, 2024
• Manual Googling: Feb 10, 2024
• iThenticate Software: Feb 23, 2024 (6%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6