Limits of laryngeal mask airway in patients after cervical or oral radiotherapy

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, ail 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.