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Tonsillectomy is a commonly performed surgical procedure in both children and adults. Because airway access is shared by anaesthetist and surgeon, and because airway soiling with blood and other debris can occur, it presents unique risks for complications related to the airway and respiration throughout the peri-operative period. Controversy exists over how to best manage the airway during a tonsillectomy (1,2), with particular theoretical benefits attributable to both endotracheal intubation and use of the laryngeal mask airway (LMA) (3). Both of these airway management methods have advantages and disadvantages. Endotracheal intubation may be more likely to cause airway irritation, leading to a greater risk of coughing, gagging, laryngospasm and stridor, although there are conflicting data on this outcome (4-7). On the other hand, the LMA provides less airway protection against aspiration, with blood and possibly gastric contents Original Article

Airway complications in a retrospective audit of 1,142 tonsillectomies: further evidence for safety of the laryngeal mask airway