Supraglottic high frequency jet ventilation for laser microlaryngosurgery

Background: It's been widely known that CO₂ laser is more efficient in treating papilloma, granuloma, web and stenosis of larynx. But if those lesions are in the posterior larynx or subglottis, the operation field will be greatly affected by the existence of endotracheal tube. For the worse cases, it may even impede the performance of operation. Therefore, it's been the study target to explore a way to obtain both safe anesthesia and good operation field under the absence of intubation. Methods: We applied supraglottic high frequency jet ventilation and total intravenous anesthesia for laser microlaryngosurgery. There were sixteen patients with lesions in posterior larynx or subglottis receiving operation from July to December in 1997. Results: The average operation time was 11.7 minutes. The mean recovery time was 7.1 minutes. During the operation procedure, the patients' heart beat, blood pressure and O₂ saturation had been quite stable. The operations for the 16 cases were successful and there was no patient with dyspnea after operation. Conclusions: With careful patient selection and through communication with anesthesiologist, it's a safe and efficient method to manage patients with subglottic or posterior laryngeal lesions by laser microlaryngosurgery under supraglottic high frequency jet ventilation.