Airway management and CO2 laser treatment of subglottic and tracheal stenosis using flexible bronchoscope and laryngeal mask anesthesia

Mild-to-moderate subglottic and tracheal stenosis can be effectively treated endoscopically, but safe airway management is a key concern. Options have included tracheotomy, jet ventilation, and intermittent apnea technique, each of which has limitations. This article presents the authors' endoscopic surgical technique using laryngeal mask anesthesia during CO2 laser treatment of subglottic and tracheal stenosis. A flexible bronchoscope is passed through a laryngeal mask airway and permits continuous ventilation during treatment with a flexible CO2 laser fiber or balloon dilator. This technique allows excellent airway control, access, and visualization during surgery and is easily mastered by anesthesiologists and otolaryngologists.