Using the laryngeal mask airway to manage the difficult airway

Before 1990, the choice of an airway device essentially was limited to the facemask or the endotracheal tube. Since then, a number of novel supraglottic airway devices have been developed. The laryngeal mask airway (LMA) was introduced to the United States in 1991 after 3 years of use in the United Kingdom and other countries. Today the LMA has a clearly established role as an airway device in the elective setting when neither the procedure nor the patient require tracheal intubation. Perhaps more importantly, the LMA also has proved extremely useful in managing the difficult airway. This article reviews the use of the various LMA devices to manage the difficult upper airway.