Indications of transnasal humidified rapid‐insufflation ventilatory exchange (THRIVE) in laryngoscopy, a prospective study of 19 cases

In suspension microlaryngoscopy, the endotracheal tube, which hampers the vision of the subglottic plane, may disturb the surgery. Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) provides effective aventilatory mass flow under deep sedation and seems an interesting approach to operate without endotracheal tube. The objective is to evaluate the indications, the technique and the failures of THRIVE in laryngeal surgery. This prospective study included 19 patients over the age of 18, that overwent laryngeal surgery under laryngosuspension. The exclusion criteria was surgical procedure requiring the use of a laser. Twenty-two interventions with THRIVE were analyzed. Three surgical indications were found: i) subglottic stenosis, ii) vocal fold augmentation, iii) tracheal and laryngeal papillomatosis. THRIVE is an innovating technique that is easy to implement from an anesthetic and surgical point of view. It saves time and it offers surgical comfort with more space and better visualization of the subglottis. The laser is however not indicated. In order to avoid secondary oro-tracheal intubation, anesthetic contra indications must be found. This article is protected by copyright. All rights reserved.