Abstract
Purpose
To test the efficacy of the LMA in patients with previous oral or cervical radiotherapy, without upper airway obstruction.
Methods
In nine patients after oral or cervical radiotherapy, efficiency of ventilation was assessed after induction of general anaesthesia and LMA insertion. Fibreoptic examination through the tube was performed to check the position of LMA
Results
In patients who had had oral radiotherapy, all five had limited mouth opening and in two, LMA insertion was difficult but permitted good ventilation. In the four patients who had had cervical radiotherapy, LMA insertion was easy but, in two, the lungs were difficult to ventilate and, in two, the lungs could not be ventilated and orotracheal intubation was required.
Conclusion
In patients with limitation of mouth opening after oral radiotherapy, LMA may represent an alternative to tracheal intubation. In patient with cervical sclerosis after radiotherapy; the use of LMA should be avoided.
Résumé
Objectif
Tester l’efficacité du masque laryngé chez des patients ayant subi une radiothérapie orale ou cervicale, sans obstruction des voies aériennes supéneures.
Méthodes
Chez neuf patients ayant subi de la radiothérapie, la qualité de la ventilation a été appréciée après induction de l’anesthésie générale. Une fibroscopie à travers le tube a été effectuée pour apprécier la position du masque laryngé.
Résultats
Chez les patients qui ont eu une radiothérapie orale, cinq avaient une limitation de l’ouverture de bouche. Chez deux d’entre eux, la pose du masque a été difficile mais a permis une bonne ventilation. Chez les quatre patients ayant eu une radiothérapie cervicale, la pose a été facile; la ventilation a été difficile chez deux d’entre eux et impossible chez les deux autres, nécessitant l’intubation trachéale.
Conclusion
Chez les patients ayant une limitation de l’ouverture buccale après radiothérapie orale, le masque laryngé peut être une alternative à l’intubation. Chez les patients ayant une sclérose cervicale après radiothérapie de sclérose cervicale consécutive à la radiothérapie, il faut éviter d’utiliser le masque laryngé.
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Giraud, O., Bourgain, J.L., Marandas, P. et al. Limits of laryngeal mask airway in patients after cervical or oral radiotherapy. Can J Anaesth 44, 1237–1241 (1997). https://doi.org/10.1007/BF03012769
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DOI: https://doi.org/10.1007/BF03012769