The case against the laryngeal mask airway for anesthesia in oral and maxillofacial surgery

Abstract

In 1983, Dr Archie Brain first described his new type of airway device, the laryngeal mask. 1 Since then, more than 2,000 scientific articles have been written on the laryngeal mask airway (LMA), and the device has moved from prototype to routine use. The LMA is based on Brain’s belief that the most elegant and least invasive way to join the anatomical airway and the artificial airway involves an end-to-end junction at the glottis. 2 The LMA became commercially available in the United Kingdom in 1988, 3 and in 1991 was approved for use by the US Food and Drug Administration. After 100 million uses 4 in more than 60 countries 5 and the creation of 4 additional commercially available types, the LMA’s safety and efficacy have been well documented. However, with any medical device, there are advantages and disadvantages to its use. When viewed in the narrow context of the oral and maxillofacial surgeon’s practice, there are significant drawbacks to its routine use. In fact, the case against the LMA in everyday oral and maxillofacial surgery (OMFS) practice is based on problems with its application rather than the device itself.