The Use of a Laryngeal Mask Airway After a Prolonged Suspension Laryngoscopy to Preserve a Vocal Cord Fat Graft

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A 62-yr-old man presented for a microdirect laryngoscopy and vocal cord fat grafting under jet ventilation. After a prolonged laryngoscopy, the patient developed hypercapnea and upper airway obstruction secondary to traumatic epiglottitis. The placement of a laryngeal mask airway provided ventilation and allowed for direct visualization of the patient’s inflamed epiglottis without disruption of the patient’s fat graft. Because of its placement above the cords and its effectiveness in providing adequate ventilation, we propose intermittent laryngeal mask airway ventilation as a bridge, in lieu of endotracheal intubation, in microdirect laryngoscopy cases in which ventilation during emergence may be difficult and the insertion of an endotracheal tube would disrupt the surgical procedure.

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