General anesthesia under spontaneous respiration without respiratory support or airway instruments is the optimal anesthetic technique for pediatric ENT laryngoscopists. This allows observation of the natural condition of the larynx in children, who are much smaller than adults, as well as identification of lesions and laser surgery. Achieving the appropriate depth of anesthesia requires a trained anesthesiologist and close collaboration between the otolaryngologist and the anesthesiologist. The risks associated with this technique include hypoxia, gastroesophageal reflux, laryngospasm, and intraoperative movement of the child, which must be managed during surgery. We herein report how we performed laryngoscopic surgery in children at our institution under non-intubated general anesthesia with spontaneous respiration.
