Jet ventilation in endolaryngeal surgery

Yıl 2017, Cilt: 27 Sayı: 6, 107 - 113, 20.12.2017

Demet Altun Emre Çamcı

Öz

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.

Anahtar Kelimeler

Anesthesia management, endolaryngeal surgery, jet ventilation

Endolarengeal cerrahide jet ventilasyon

Öz

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

Anahtar Kelimeler

Anestezi yönetimi, endolarengeal cerrahi, jet ventilasyon

Kaynakça

• Evans KL, Keene MH, Bristow AS. High-frequency jet ventilation--a review of its role in laryngology. J Laryngol Otol 1994;108:23-5.
• Fritzsche K, Osmers A. Anesthetic management in laryngotracheal surgery. High-frequency jet ventilation as strategy for ventilation during general anesthesia. Anaesthesist 2010;59:1051-61. [Abstract]
• Janjević D, Jović R. High Frequency Jet Ventilation and laryngeal surgery, clinical practice. Med Pregl 2008;6:57-61. [Abstract]
• Evans E, Biro P, Bedforth N. Jet ventilation. Continuing Education in. Anaesthesia, Critical Care & Pain 2007;7:2-5.
• Ng A, Russell WC, Harvey N, Thompson JP. Comparing methods of administering high-frequency jet ventilation in a model of laryngotracheal stenosis. Anesth Analg 2002;95:764-9.
• Hu A, Weissbrod PA, Maronian NC, Hsia J, Davies JM, Sivarajan GK, et al. Hunsaker Mon-Jet tube ventilation: a 15-year experience. Laryngoscope 2012;122:2234-9.
• Biro P. Jet ventilation for surgical interventions in the upper airway. Anesthesiol Clin 2010;28:397-409.
• Rubin JS, Patel A, Lennox P. Subglottic jet ventilation for suspension microlaryngoscopy. J Voice 2005;19:146-50.
• Jaquet Y, Monnier P, Van Melle G, Ravussin P, Spahn DR, Chollet-Rivier M. Complications of different ventilation strategies in endoscopic laryngeal surgery: a 10-year review. Anesthesiology 2006;104:52-9.
• Davies JM, Hillel AD, Maronian NC, Posner KL. The Hunsaker Mon-Jet tube with jet ventilation is effective for microlaryngeal surgery. Can J Anaesth 2009;56:284-90.
• Orloff LA, Parhizkar N, Ortiz E. The Hunsaker Mon-Jet ventilation tube for microlaryngeal surgery: optimal laryngeal exposure. Ear Nose Throat J 2002;81:390-4.
• Khan I, Shakeel M, Nagaraja R, Ram B, Thomas AD. A Hunsaker Mon-Jet tube trapped in the larynx. J Laryngol Otol 2011;125:1204-5.
• Cook TM, Alexander R. Major complications during anaesthesia for elective laryngeal surgery in the UK: a national survey of the use of high-pressure source ventilation. Br J Anaesth 2008;101:266-72.
• Gilbert TB. Gastric rupture after inadvertent esophageal intubation with a jet ventilation catheter. Anesthesiology 1998;88:537-8.
• Biro P, Wiedemann K. Jet ventilation and anaesthesia for diagnostic and therapeutic interventions of the airway. Anaesthesist 1999;48:669-85. [Abstract]
• Conion EC. High-frequency jet ventilation Anaesthesia Tutorial of the Week 271; ATOTW weekly; 2012.