Jet ventilation in endolaryngeal surgery

Abstract

Endolaryngeal surgery, which is performed for the diagnosis and treatment of the benign and malignant lesions of the larynx, requires that the anesthetist and surgeon work in the same area during the procedure. During the endoscopic microsurgical procedures of the larynx direct examination-biopsy, microlaryngeal resection, laser cordectomy , small-diameter endotracheal tubes are preferred for the better visualization of the surgical field while providing ventilation. Nevertheless, sometimes conventional endotracheal tubes with such diameter may also block vision and complicate the surgery. In this situation, jet ventilation option with a thin cannula should be considered. Today, jet ventilation is used in trachea and larynx surgery, bronchoscopy, pneumonectomy and bronchopleural fistulas. In this review, we evaluated the jet ventilation technique, the advantages and disadvantages of this technique compared to conventional methods, principles of application and the anesthesia management during jet ventilation.

Keywords

• Anesthesia management, endolaryngeal surgery, jet ventilation

Endolarengeal cerrahide jet ventilasyon

Abstract

Larenksin benign veya malign lezyonlarının tanı ve tedavisinde uygulanan endolarengeal cerrahi, anestezist ve cerrahın işlem süresince aynı bölgede çalışmalarını gerektirir. Larenksin endoskopik mikrocerrahi işlemleri direkt tetkik-biyopsi, mikrolarengeal rezeksiyon, lazer kordektomi sırasında ventilasyon sağlanırken cerrahi alanın daha iyi görüntülenmesi için küçük çaplı endotrakeal tüpler tercih edilmektedir. Buna rağmen, bazen bu çaptaki konvansiyonel endotrakeal tüpler de görüntüyü engelleyerek cerrahiyi güçleştirebilmektedir. Bu durumda, ince bir kanülle jet ventilasyon seçeneği değerlendirilmelidir. Günümüzde, jet ventilasyon trakea ve larenks cerrahisinde, bronkoskopide, pnömektomide ve bronko-plevral fistüllerde kullanılmaktadır. Bu derlemede jet ventilasyon tekniği, bu tekniğin konvansiyonel yöntemlere göre avantaj ve dezavantajları, uygulama prensipleri ve jet ventilasyon sırasında anestezi yönetimi değerlendirildi

Keywords

• Anestezi yönetimi, endolarengeal cerrahi, jet ventilasyon

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