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International Bulletin of Otorhinolaryngology

Laryngeal Mask or Endotracheal Intubation in Patients with Laryngeal Carcinoma

Ts. Marinov, M. Belitova, T. Popov, D. Konov, M. Tsekova-Chernopolska

Abstract

Theoretical basis: The presence of laryngeal carcinoma requires precise assessment of the feasibility of endotracheal intubation. Difficult intubation requires preparation of a preliminary plan for ventilation if intubation proves impossible. Some authors report successful use of supraglottic devices when difficult intubation is expected. On the other hand, improper use of the above mentioned may lead to serious complications.
The Aim of the study is to determine the advantages and describe the problems of ensuring upper airway patency by the use of laryngeal mask or endotracheal tube.
Results: Airway dead space is higher in patients ventilated by laryngeal mask compared to patients ventilated by endotracheal tube. Airway resistance is increased in patients ventilated by endotracheal tube due to reduced airway diameter and reflective airway constriction. Airway resistance is lower in patients ventilated by laryngeal mask because of the larger tube diameter of the device and lack of direct irritation of the trachea. The increase in arterial pressure and heart rate after positioning the laryngeal mask is less than in endotracheal intubation. Intraocular pressure is increased to a lesser extent with the use of laryngeal mask compared to endotracheal intubation. The lower esophageal sphincter tone can be reduced when using laryngeal mask compared to endotracheal tube. There is no consensus on the use of the laryngeal mask in patients with carcinoma of the larynx and the neck.
Conclusion: The technique of ventilation of patients with different degree of laryngeal obstruction is still under discussion.

Keywords

Laryngeal mask, endotracheal intubation, carcinoma of the larynx

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References

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DOI: http://dx.doi.org/10.14748/orl.v14i1.6777

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