• Leonard Pott, John T Swick, and Brendan C Stack.
• Department of Anesthesia, Penn State College of Medicine, Hershey, PA, USA.
• Arch Otolaryngol. 2007 Mar 1;133(3):266-9.

ObjectiveTo study the feasibility of using laryngeal mask anesthesia (LMA) with bronchoscopic evaluation of recurrent laryngeal nerve (RLN) integrity when stimulated.DesignSingle-institution prospective case series.SettingA single, mid-Atlantic region academic medical center.PatientsTwenty-seven adult volunteers.InterventionsLaryngeal mask anesthesia for thyroid surgery, monitored by flexible laryngoscopy and nerve integrity testing.Main Outcome MeasuresSuccess rates for LMA use in thyroid surgery, bronchoscopic visualization of laryngeal glottis, and documentation of RLN integrity following surgery.ResultsWe report our experience on 27 consecutive cases in which LMA with RLN stimulation was used for thyroid surgery. Twenty-five of 27 patients underwent successful LMA and visual documentation of RLN integrity by bronchoscopic inspection of nerve stimulation.ConclusionsDirect visualization of vocal cords using a fiberoptic bronchoscope via an LMA provides a safe and feasible method of laryngeal assessment following thyroid dissection. Continuous real-time video monitoring may be the next step in development of this technique as a patient safety measure for thyroid and parathyroid surgery.

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