2006 Volume 26 Issue 7 Pages 679-682
A 7-month-old girl was scheduled to undergo tracheostomy for laryngomalacia. Since the previous surgery revealed that she had a difficult airway, our plan was fiberscopic tracheal intubation through a Soft Seal Laryngeal Mask™ (S-LMA) . A #1.5 S-LMA was cut at the tube part about 10 cm from the tip of the cuff and attached to a 7.5 mm I. D. tracheal tube connector. Anesthesia was induced using oxygen, nitrous oxide and sevoflurane, and then the S-LMA was inserted. The bronchofiberscope was smoothly inserted into the trachea, allowing tracheal intubation while utilizing the bronchofiberscope as a stylet, and removal of the S-LMA following intubation.
The total length of a cut S-LMA should be about 1 cm longer than the expected depth of the tracheal tube used. The larger the connector used for the cut LMA, the more space you can ensure for fiberoptic procedures, and thus a larger tracheal tube can be inserted.
