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Year : 2016  |  Volume : 60  |  Issue : 6  |  Page : 447  

Tracheo-oesophageal fistula with sub-glottic stenosis: Another option for airway management


Department of Anaesthesiology, Pain Medicine and Intensive Care, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication2-Jun-2016

Correspondence Address:
Dr. Renu Sinha
R. N. 376, R. P. Center, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.183402

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How to cite this article:
Sinha R, Shwetha S. Tracheo-oesophageal fistula with sub-glottic stenosis: Another option for airway management. Indian J Anaesth 2016;60:447

How to cite this URL:
Sinha R, Shwetha S. Tracheo-oesophageal fistula with sub-glottic stenosis: Another option for airway management. Indian J Anaesth [serial online] 2016 [cited 2020 Jun 5];60:447. Available from: http://www.ijaweb.org/text.asp?2016/60/6/447/183402

Sir,

We read with interest the article, 'Complicated airway management in a neonate of congenital tracheo-oesophageal fistula with subglottic stenosis' by Kerai et al.[1] We congratulate the authors for their excellent management. We faced similar problem in two cases of congenital tracheo-oesophageal fistula (TOF) with sub-glottic stenosis. In our cases, tracheostomy was required for securing definitive airway due to the same reasons as suggested by authors. However, we used Ambu™ laryngeal mask airway (LMA) size 1 to maintain the airway during tracheostomy. LMA has been used previously for tracheostomy in a neonate.[2] Supra-glottic airway device (SAD) has many advantages over face mask during tracheostomy. SAD helps in ventilation and also keeps the neck area sterile for tracheostomy. Assisted ventilation will be easier with SAD compared to face mask, and chances of aspiration during the procedure will be less. In pre-term infant, face mask ventilation is difficult; further, hands holding the face mask will encroach surgical area and there will be risk to sterility during tracheostomy. In case of difficult ventilation, movement of the head and neck will lead to difficulty in surgical procedure.

We suggest that SAD is a better option over face mask to maintain airway during tracheostomy in pre-term infants with TOF with sub-glottic stenosis.

 
   References Top

1.
Kerai S, Gupta A, Kohli JK, Sharma J, Sood R. Complicated airway management in a neonate of congenital trachea-oesophageal fistula with subglottic stenosis. Indian J Anaesth 2016;60:142-3.  Back to cited text no. 1
  Medknow Journal  
2.
Denny NM, Desilva KD, Webber PA. Laryngeal mask airway for emergency tracheostomy in a neonate. Anaesthesia 1990;45:895.  Back to cited text no. 2
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