Reply to the Comment on the Article “Simple Maneuver to Tide Over the Crisis Due to Intraoperative Malfunctioning of a Pilot Balloon”

Comment on the Article “Simple Maneuver to Tide Over the Crisis Due to Intraoperative Malfunctioning of a Pilot Balloon”

Thank you for your interest and valuable comments on our article.[1] We do agree that it is not a novel technique and we have clearly mentioned in our manuscript that maneuvers similar to ours are already described in the literature to manage cuff leak, where the authors introduced intravenous cannula into the inflation tube and attached a syringe directly to it and inflated the cuff.[2] [3] As correctly said by the authors, there are several reports of maneuvers similar to ours being performed to manage tracheal tube cuff leak. But in contrast to the reports of similar techniques being followed to manage tracheal tube cuff leak in supine position with easy access to patient's airway, we reported a simple maneuver to tackle tracheostomy tube cuff leak in a patient undergoing cervical spine surgery in prone position. Again, the reports that the authors have referred to are not exactly same, but they have subtle differences. Apart from a simple maneuver to manage tracheostomy tube cuff leak, we even suggested a way to monitor cuff pressure in such cases where the anesthesiologist has difficult access to the patient's airway.

• References

• 1 Dhanda A, Dube SK, Agarwal S, Satyarthee GD. Simple maneuver to tide over the crisis due to intraoperative malfunctioning of a pilot balloon. J Neuroanaesth Crit Care 2018; 05 (03) 204-205
• 2 Heusner JE, Viscomi CM. Endotracheal tube cuff failure due to valve damage. Anesth Analg 1991; 72 (02) 270
• 3 Whitesides LM, Exler AS. Intraoperative damage and correction of pilot balloon during orthognathic surgery. Anesth Prog 1997; 44 (01) 38-39