Recurrent laryngeal nerve injury with the laryngeal mask

Summary.

We report a case of recurrent laryngeal nerve injury after anesthesia with the LMA and review the published cases of major pharyngolaryngeal morbidity. Prevention of this and other pharyngolaryngeal injuries probably depends on the skilled application of the correct insertion technique and the use of low intracuff pressures and volumes.

Key words:

Equipment - Laryngeal mask airway - Complications

References

• 1 Brimacombe J, Brain AIJ, Berry A. . The laryngeal mask airway: review and practical guide. London: WB Saunders Company Limited 1997
• 2 Thompsett C, Cundy JM. Use of the laryngeal mask airway in the presence of a bleeding diathesis.  Anaesthesia. 1992;  47 530-531
• 3 Marjot R. Trauma to the posterior pharyngeal wall caused by a laryngeal mask airway.  Anaesthesia. 1991;  46 589-590
• 4 Lee JJ, Brain AIJ. Laryngeal mask and trauma to uvula.   Anaesthesia. 1989;  44 1014-1015
• 5 van Heerden PV, Kirrage D. Large tonsils and the laryngeal mask airway.  Anaesthesia. 1989;  44 703
• 6 Miller AC, Bickler P. The laryngeal mask airway. An unusual complication.  Anaesthesia. 1991;  46 659-660
• 7 McKinney B, Grigg R. Epiglottitis after anaesthesia with a laryngeal mask.  Anaesth. Intens. Care . 1995;  23 618-619
• 8 Nagai K, Sakuramoto C, Goto F. Unilateral hypoglossal nerve paralysis following the use of the laryngeal mask airway.  Anaesthesia. 1994;  49 603-604
• 9 Ahmad NS, Yentis SM. Laryngeal mask airway and lingual nerve injury.  Anesthesia. 1996;  51 707-708
• 10 Laxton CH, Kipling R. Lingual nerve paralysis following the use of the laryngeal mask airway.   Anaesthesia. 1996;  51 869-870
• 11 Inomata S, Nishikawa T, Suga A, Yamashita S. Transient bilateral vocal cord paralysis after insertion of a laryngeal mask airway.  Anesthesiology. 1995;  82 787-788
• 12 Lloyd Jones FR, Hegab A. Recurrent laryngeal nerve palsy after laryngeal mask airway insertion.  Anaesthesia. 1996;  51 171-172
• 13 Morikawa M. [Vocal cord paralysis after use of the LM).  Journal of Clinical Anesthesia (Rinsho-Masui). 1992;  16 1194
• 14 Daya H, Fawcett W, Weir N. Vocal cord palsy after use of the laryngeal mask airway.   J. Laryngol. Otol.. 1996;  110 383-384
• 15 Cros AM, Pitti R, Conil C, Giraud D, Verhulst J. Severe dysphonia after use of a laryngeal mask airway.  Anesthesiology. 1997;  86 498-500
• 16 Rosenberg MK, Rontal E, Rontal M, Lebenbom-Mansour M. Arytenoid cartilage dislocation caused by a laryngeal mask airway treated with chemical splinting.  Anesth Analg. . 1997;  83 1335-1336
• 17 Brimacombe J. The advantages of the LMA over the tracheal tube or facemask: a meta-analysis.  Can. J. Anaesth.. 1995;  42 1017-1023
• 18 Harmer M. Complications of tracheal intubation. In: Latto IP, Rosen M, eds. Difficulties in tracheal intubation.  London: Bailliere Tindall. 1987;  36-48
• 19 Brimacombe J. Analysis of 1500 laryngeal mask uses by one anaesthetist in adults undergoing routine anaesthesia.   Anaesthesia. 1996;  51 76-80
• 20 Keller C, Sparr HJ, Brimacombe J. . Laryngeal mask lubrication - a comparative study of saline versus 2% lignocaine gel with cuff pressure control.  Anaesthesia. 1997;  52 592-596
• 21 Shrestha BM, Basnyat NB. Experience with the laryngeal mask airway in Nepal.  Today's Anaesthetist . 1993;  8 133-134
• 22 Majumder S, Hopkins PM. Bilateral lingual nerve injure following the use of the laryngeal mask airway.  Anaesthesia. 1998;  53 184-186
• 23 Wynn JM, Jones KL. Tongue cyanosis after laryngeal mask insertion.  Anesthesiology. 1994;  80 1403-1404
• 24 Harada M. Transient swelling of the parotid glands following laryngeal mask airway.  Can. J. Anaesth.. 1992;  39 745-746
• 25 Brimacombe J, Berry A. The laryngeal mask airway - anatomical and physiological implications.  Acta Anaesthesiol. Scand.. 1996;  40 201-209
• 26 Charters P. Digital exploration and the laryngeal mask.   Anaesthesia . 1996;  51 990
• 27 Lumb AB, Wrigley MW. The effect of nitrous Oxide an laryngeal mask cuff pressure. In vitro and in vivo studies.  Anaesthesia. 1992;  47 320-323
• 28 Hamakawa T, Nakamura S, Kawasaki Y. [Intracuff pressure of the LM and pressure on the pharynx].  Journal of Clinical Anesthesia (Rinsho-Masui). 1993;  17 1165-1167
• 29 Kron SS, Schwartz DE, Cohen NH. Questionable effectiveness of cricoid pressure in preventing aspiration.  Anesthesiology. 1995;  83 431-432
• 30 Berry A, Brimacombe J, McManus KF, Goldblatt M. An evaluation of the factors influencing selection of the optimal size of laryngeal mask airway in normal adults.  Anaesthesia. 1998;  53 565-570
• 31 Voyagis GS, Batziouulis PG, Secha-Doussaitou PN. Selection of the proper size of laryngeal mask airway in adults.  Anesth. Analg. . 1996;  83 663-664
• 32 Brain AIJ. Pressure in laryngeal mask airway cuffs.  Anaesthesia. 1996;  51 603
• 33 Brimacombe J, Berry A. Insertion of the laryngeal mask airway - a prospective study of four techniques.  Anaesth. Intens. Care. 1993;  21 89-92
• 34 Burgard G, Mollhoff T, Prien T. The effect of laryngeal mask cuff pressure on postoperative sore throat incidence.  J. Clin. Anesth. . 1996;  8 198-201
• 35 Rieger A, Brunne B, Striebel HW. Intracuff pressures do not predict laryngopharyngeal discomfort after use of the laryngeal mask airway.  Anesthesiology. 1997;  87 63-67
• 36 Keller C, Puehringer F, Brimacombe J. The influence of cuff volume on oropharyngeal leak pressure and fibreoptic position with the laryngeal mask airway.  Br. J. Anaesth.. 1998;  81 186-187
• 37 Asai T, Howell TK, Koga K, Morris S. Appropriate size and inflation of the laryngeal mask airway.  Br. J. Anaesth.. 1998;  80 470-474