Lung isolation with laryngeal mask for tracheoplasty in excessive dynamic airway collapse- a useful technique

Abstract Background Excessive dynamic airway collapse (EDAC) is a rare cause of expiratory central airway obstruction (ECAC). Standard lung isolation with double-lumen tubes (DLTs) can be challenging in such patients, as they may impede assessment, placement of multiple sutures required for plication and risk airway trauma. Case We describe a novel technique for airway management in a series of patients with EDAC who underwent posterior splinting tracheoplasty. We present one of the cases here to highlight the airway management employed; an i-Gel supraglottic airway device with bronchial blocker placement under fibreoptic guidance, enabling effective one-lung ventilation without DLT. The patient tolerated the procedure well and was weaned from the ventilator at the end of the surgery. Conclusion Placement of a bronchial blocker via an i-Gel supraglottic airway device provided reliable lung isolation and facilitated surgical access for complex tracheal surgery. This technique may be considered an alternative to DLTs in selected thoracic cases.