TRACHEAL STENOSIS SURGERY; AIRWAY MANAGEMENT

To highlight the problems and solutions in airways management in patients with tracheal stenosis undergoingsurgical interventions and to highlight the alternative methods of airway control where high frequency ventilatory facility is not available. StudyDesign: Case series study. Place and Duration: Combined Military Hospital Rawalpindi from 1st Jan 2004 to 30th June 2007. Patients andMethods: Twenty nine patients of both sex and all age groups presenting with difficulty in breathing due to tracheal stenosis undergoing surgicalintervention on trachea have been included. All the patients were managed under general anaesthesia. Nasogastric tube 10 Fr, suctioncatheter, laryngeal mask airway or mask ventilation was used for initial ventilation where conventional endotracheal tube of even smallest sizedid not work. Results: Small size endotracheal tube were used in twenty four patients. Difficulty was faced in five patients. In these patientsendotracheal tube of smallest size available could not be passed and we had to provide ventilation by innovative measures like nasogastric tube10Fr in one, suction catheter 10Fr in two, laryngeal mask airway in one and mask ventilation in one. There was no mortality. Conclusions:Adequate ventilation during tracheal stenosis surgery can be very difficult in some cases. Therefore a thorough understanding, a tier of flexibleplans and a variety of ventilating means should be arranged before administering anaesthesia.Nasogastric tube 10Fr or suction catheter ofsimilar size are suitable alternative if facility for high frequency ventilation is not available.