Chapter 44. Airway Management of a Patient with a Difficult Airway Requiring Microlaryngoscopy, Tracheoscopy, and Pharyngoesophageal Dilation
Which of the following is NOT useful to provide oxygenation and ventilation during suspension laryngoscopy?
A. delivering oxygen via a narrow-bore catheter located above the glottis
B. through a regular cuffed polyvinylchloride (PVC) tube in the trachea
C. intermittent apnea technique
D. extracorporeal membrane oxygenation
(B) While all the options are useful to provide oxygenation and ventilation during suspension laryngoscopy, the regular PVC tube is too big and may obscure the view of the surgical field during laryngeal surgery.
Which of the following is NOT a characteristic of a microlaryngeal tube (MLT)?
A. It has a narrow internal diameter designed to allow increased view of the surgical field during laryngeal surgery.
B. It is available in many sizes, with internal diameters of from 4.0 to 6.0 mm
C. MLTs have an adult-sized cuff, ensuring that the adult trachea can be sealed to facilitate positive pressure ventilation.
D. MLTs are also longer than their pediatric size endotracheal tubes.
E. MLTs do not obscure the posterior glottis and the inter-arytenoid region.
(E) Even though the MLTs have smaller lumen, they do obscure the posterior glottis and the inter-arytenoid region.
Which of the following is NOT true about transtracheal jet-ventilation (TTJV)
A. TTJV has been reported with total complication rate of 51%
B. TTJV has a high incidence (42%) of device failure
C. Inexperienced practitioners tend to have higher complication rates with TTJV.
D. Incidence of barotrauma is low with TTJV.
E. TTJV has a high incidence of ventilation-related complications than transglottic jet-ventilation (TGJV).
(D) A recent systematic review35 showed that TTJV in the “cannot intubate, cannot oxygenate” situation to be associated with a 42% incidence of device failure, 32% incidence of barotrauma, and total complication rate of 51%.