Laryngeal Mask Airway Rescue After Failed Intubation for Tracheal Resection in Severe Subglottic Stenosis: A Case...

Severe subglottic stenosis poses a significant challenge during tracheal resection, particularly when conventional endotracheal intubation fails. The role of the laryngeal mask airway (LMA) as a rescue airway strategy in this setting remains poorly defined. We report the case of a 33-year-old woman with 80-90% postintubation subglottic stenosis undergoing tracheal resection. Attempts at intubation with small-caliber endotracheal tubes failed during induction. An LMA was inserted as a rescue strategy without traversing the stenotic segment. The LMA maintained adequate oxygenation with transient hypercapnia, which improved intraoperatively. Anesthesia was maintained with total intravenous anesthesia, and ventilation was performed manually. Following resection of the stenotic segment, cross-field intubation was performed, and anastomosis was completed without complications. The patient recovered without respiratory complications and was discharged on postoperative day 7. This case suggests that the LMA may serve as a practical rescue airway strategy in selected patients with severe tracheal stenosis when combined with thorough preoperative planning and well-defined backup strategies.