Presented as a poster at the 133rd Annual Meeting of the American Laryngological Association (ALA) Combined Otolaryngology Spring Meetings, San Diego, California, U.S.A., April 18–22, 2012.
Article first published online: 2 AUG 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 10, pages 2234–2239, October 2012
How to Cite
Hu, A., Weissbrod, P. A., Maronian, N. C., Hsia, J., Davies, J. M., Sivarajan, G. K. and Hillel, A. D. (2012), Hunsaker mon-jet tube ventilation: A 15-year experience. The Laryngoscope, 122: 2234–2239. doi: 10.1002/lary.23491
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 20 SEP 2012
- Article first published online: 2 AUG 2012
- Manuscript Accepted: 11 MAY 2012
- Manuscript Revised: 26 APR 2012
- Manuscript Received: 15 JAN 2012
- Jet ventilation;
- microlaryngeal surgery;
- Level of Evidence: 4
The Hunsaker Mon-Jet tube (HMJT) (Xomed, Jacksonville, FL) has been used effectively for subglottic ventilation. We previously reported a series of 552 patients over a 10-year period with no major complications. This is a continuation of that series with an additional 5 years of cases.
Retrospective consecutive case series.
Patients who were ventilated with the HMJT for microlaryngeal surgery at the University of Washington Medical Center over a 15-year period (1995–2010) were identified from the Voice Disorders database. Charts were reviewed for demographic data, laryngeal diagnosis, and anesthetic parameters. Main outcome measure was the rate of complications.
Fifty-seven complications occurred in 49 cases out of 839 cases (5.8% complication rate). In descending order, the complications were hypoxia (SpO2 <90%, n = 30, 3.6%), hypercarbia (end tidal CO2 of >60 mm Hg, n = 17, 2.0%), airway obstruction (n = 4, 0.5%), barotrauma (n = 2, 0.2%), seeding of blood into trachea (n = 2, 0.2%), submucosal injection of air (n = 1, 0.1%), and mucosal damage (n = 1, 0.1%). Factors associated with complications included high body mass index (P = .04), American Society of Anesthesiology class III or IV (P = .01), history of heart disease (P = .02), history of previous laryngeal surgery (P = .02), longer duration of case (P = .006), and laser use (P = .005).
Although subglottic ventilation via an HMJT is a safe alternative to traditional endotracheal intubation in an appropriately selected population, practitioners should remain vigilant about the known complications. Laryngoscope, 2012