Intubating laryngeal mask airway (ILMA) in otorhinolaryngology surgery. A case of failure

Intubating laryngeal mask airway (ILMA) is a very useful device for difficult airway management. The use of this device has not yet been studied in otorhinolaryngology surgery. The case of a 52-year-old man, weighing 104 kg, anesthetized for microlaryngoscopy due to aphonia occurred 6 months before, is reported. Traditional intubation was impossible. ILMA was easily positioned and the patient was ventilated. Intubation using ILMA was difficult and the operation postponed. Later, a bilateral false vocal chords hypertrophy was found. Impossible intubation using ILMA is a rare occurrence, less than 10% of cases. From previous evidence failed intubations are caused by anatomical anomalous formations, often predictables by clinical history. Blind intubation with ILMA is not, probably, the first alternative in these cases. Fiberoptic equipment intubation or use of ILMA with fiberoptic bronchoscope must be considered in these situations for possible better results. The use of ILMA in otorhinolarynogology surgery must be investigated with a specific study because there are only few experiences on this subject.