We describe the use of a laryngeal mask airway in three adult patients
whose mouth opening varied from 12 mm to 18 mm. The first patient's i
ncisal opening was 12 mm. His airway was otherwise normal and the stan
dard laryngeal mask was used as the definitive airway for the 90 min r
evision of facial scars and bone graft to mandible. The second patient
, who had an incisal opening of 18 mm, was scheduled for posterior fos
sa craniotomy. She adamantly refused awake fibreoptic tracheal intubat
ion. Following induction of general anaesthesia, a standard laryngeal
mask was inserted and through this, fibreoptic intubation was performe
d. The third patient, in addition to a mouth opening of only 18 mm, ha
d limited neck movement from previous flap reconstruction following ma
ndibulectomy, hemiglossectomy and radical neck dissection. For three m
ore reconstructive head and neck procedures that ranged from 90 min to
nine hours, the flexible reinforced laryngeal mask was inserted under
topical anaesthesia and its correct position confirmed by fibreoptic
laryngoscopy before induction of general anaesthesia. Maintenance of a
naesthesia in all cases was unevenful and there were no postoperative
complications.