Use of the laryngeal mask airway in otologic surgery

The combination of intravenous sedation and local infiltration anesthesia is routinely utilized in otologic surgery. Advantages over general anesthesia with endotracheal intubation include ease and speed of induction and emergence, safety, and decreased postoperative discomfort. Anatomic and physiological patient constraints may preclude the use of intravenous sedation and anesthetists inexperienced in this technique may find it difficult to achieve a consistent level of anesthesia appropriate for major otologic surgery. Administration of anesthesia using the laryngeal mask airway (LMA) has been proposed to offer many of the advantages of intravenous sedation with less risk of oversedation and obstructive apnea.

A retrospective chart review.

A review of 100 consecutive adult and pediatric patients undergoing major otologic procedures in which the LMA was utilized.

All laryngeal masks were introduced without a laryngoscope and successful placement was accomplished on the first attempt in 98%. Procedures were performed under spontaneous ventilation and in only one instance was surgery temporarily interrupted because of patient movement. No major complications occurred and no patients required endotracheal intubation. Only three patients complained of mild throat discomfort in the immediate postoperative period.

The laryngeal mask airway is a safe and effective means of providing anesthesia during major otologic surgery.