Emergency use of the laryngeal mask airway in severe upper airway obstruction caused by supraglottic oedema

We report two cases of severe upper airway obstruction caused bysupraglottic oedema which developed rapidly at the time of anaesthesia.Conventional methods to relieve the obstruction failed and it was onlyovercome when a laryngeal mask airway (LMA) was inserted and positivepressure applied manually during inspiration. In one case a fibrescope waspassed via the LMA and this revealed two cushions of oedematous false vocalcords protruding into the bowel of the LMA which were pushed out of the waywhen positive pressure was applied during inspiration. We believe that theLMA should be considered in the emergency management of severe upper airwayobstruction even when this involves supraglottic oedema.