Can anesthesia with laryngeal mask airway be used for total rhinoplasty?

Question

Can anesthesia with laryngeal mask airway be used for total rhinoplasty? Is it safe (LMA )?

Semih Yildiz, MD, FEBOPRAS · Answer

A laryngeal mask airway can be used for some rhinoplasty cases, but it is not the best choice for every patient or every operation. Rhinoplasty is shared-airway surgery, and blood or irrigation fluid can enter the throat. A cuffed endotracheal tube generally provides more secure airway protection and is often preferred for a long or complex total rhinoplasty.

An LMA may be reasonable for a carefully selected healthy patient, a shorter procedure with limited bleeding, and a surgical/anesthesia team experienced with that technique. The decision also depends on reflux or aspiration risk, obesity, sleep apnea, airway anatomy, procedure length and the surgeon’s planned work. This choice should be made by the anesthesiologist together with the surgeon after reviewing your medical history; it should not be selected solely to avoid intubation.

Eric M. Joseph, MD · Answer

The benefit of an orotracheal tube and general anesthesia during rhinoplasty surgery, is that the tip of the tube has a small cuff on it that prevents blood and other mucus from getting into the lungs, thus preventing aspiration pneumonia. I do not believe an LMA would be as protective for somebody's Airway. I hope this helps. Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. I think endotracheal intubation with a protected airway is much safer. Of course it is extremely important to have a board-certified anesthesiologist taking care of you the entire time. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  There is a variable amount of bleeding in any rhinoplasty.  The whole point of performing endotracheal intubation is to protect the airway and prevent any blood from getting into your airway.  The laryngeal mask definitely does not work as well and also gets in the way of the surgeon.  By far, endotracheal intubation is a much better way to go.  I hope that helps.

Can anesthesia with laryngeal mask airway be used for total rhinoplasty?

Answers (4)

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