Comparative Success Rate of Laryngeal Mask Airway Verses Endotracheal Tube for ENT Procedures
Abstract
Background: Airway selection during short ear, nose and throat procedures must balance reliable ventilation and airway protection against insertion-related physiological responses and postoperative airway morbidity. Objective: To compare first-attempt placement success of the laryngeal mask airway and endotracheal tube in adults undergoing elective short ENT procedures. Methods: This single-center comparative study included 46 adults aged 18–50 years at Mayo Hospital, Lahore. Participants were assigned in equal numbers to LMA and ETT groups (23 per group). The primary outcome was first-attempt placement success. Secondary observations included insertion attempts, oxygenation, airway pressures and perioperative complications. Analyses were performed using IBM SPSS Statistics version 26.0; categorical comparisons used exact methods where cell counts were small. Results: First-attempt placement was reported in 21/23 patients receiving LMA (91.3%) and 19/23 receiving ETT (82.6%). The absolute difference was 8.7 percentage points (95% CI −12.2 to 29.4), with a risk ratio of 1.11 (95% CI 0.88–1.39; Fisher’s exact p=0.665). Across the cohort, the most frequent postoperative events were sore throat (10/46, 21.7%), hoarseness (8/46, 17.4%) and cough (5/46, 10.9%). Conclusion: LMA showed a numerically higher first-attempt success rate, but the small sample produced substantial uncertainty and did not demonstrate a statistically reliable difference. Larger prospective studies with prespecified allocation and device-specific safety outcomes are required.
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