Tracheal stenosis is a clinical problem that can lead to airway obstruction and other serious complications. The lesion responsible for the stenosis can be treated surgically or through endoscopic therapy. In recent years, there has been an increasing tendency to use interventional bronchoscopic techniques through fiberoptic bronchoscopy (FOB) for treating tracheal stenotic lesions.1, 2

Laryngeal mask airway (LMA) is a supraglottic airway device that is placed above the larynx and provides excellent visibility of the glottis and subglottis; thus, it is feasible for treating subglottic and upper tracheal lesions. This device was first introduced in 1988 and has advantages such as easy and rapid insertion (i.e., no need for a laryngoscope), effective protection of the airway during general anesthesia or deep sedation, easy access to the glottis and upper trachea, and less involvement of the anesthesiologist's hands.3, 4, 5

We used LMA for ventilation in six patients with tracheal stenosis (consisting of 3 cases of postintubation tracheal stenosis, 1 case of idiopathic subglottic stenosis, 1 case of tracheal stenosis secondary to Wegener granulomatosis, and 1 case of tumoral invasion). The patients underwent interventional bronchoscopy via FOB. The procedure was completed without any serious complications or episodes of hypoxia.

In our patients, LMA was a suitable airway that provided excellent visualization of the vocal cords, glottis, and trachea, and provided easy access to these structures. It also maintained effective gas exchange in the patients. One patient developed hypoxia while undergoing rigid bronchoscopy; however, with the placement of LMA, this problem was quickly resolved. Furthermore, a bronchoscopist would be elated and proud about passing the FOB through the large bore of the LMA. In one patient who had bleeding that occurred as a complication of the intervention, the bronchoscopist was able to control the hemorrhage effectively, and the patient's oxygenation status was stably maintained. The LMA has meanwhile become tolerable in clinical use: only one patient complained of a moderately sore throat of our many patients in whom we used the LMA.

Hashmi et al⁶ also report LMA as a safe device for managing the airway because it offers good visualization and is less traumatic to the vocal cords when used in conjunction with the flexible endoscope for laryngeal and upper tracheal interventions. Jameson and Moses⁷ have similarly stated that the advantages of LMA are easy access to the subglottic region, simple maneuvering of the FOB, and excellent lung ventilation. Chhetri and Long⁸furthermore propose that the LMA is a simple and safe alternative to other devices for ventilating patients while performing endoscopic laser treatment for subglottic stenosis. In addition to these benefits, Yavaşcaoğlu et al⁹mention that, in FOB for subglottic stenosis cases, the LMA offers a better view and better accessibility to the lesion because it is placed above the glottis.

Based on the innate characteristics of the LMA—namely, supra-laryngeal placement, large diameter, provision of secure and effective ventilation, and its toleration by patients—we conclude that the LMA can be a valuable alternative for airway management during interventional bronchoscopic procedures for stenosis and lesions in the glottis, subglottis, and upper trachea.