The Global Rise of the Laryngeal Mask : New Advancements in Clinical Adoption

 

Laryngeal Mask

The laryngeal mask airway, commonly known as the LMATM, is a supraglottic airway device that was invented by British anesthesiologist Dr. Archie Brain in 1981. Since its introduction, it has gained widespread popularity and acceptance in clinical practice across both developing and developed countries due to its effectiveness and relative ease of use compared to conventional endotracheal intubation. Some key facts about it include:

- It is inserted above the glottis instead of passing through the vocal cords like an endotracheal tube. This makes it a useful and safer alternative to endotracheal intubation in some clinical situations.

- Various sizes and models have been developed over the years to accommodate patients of different ages and anatomy. This has expanded its clinical applications.

- It helps maintain a clear Laryngeal Mask and provides a channel through which gases can be delivered to the lungs during general anesthesia or ventilation.

- Placement of the laryngeal mask is generally less technically demanding than intubation and has a faster insertion time, lowering the risk of peri-operative complications in some patients.

Widespread Clinical Adoption

Since the 1980s, use of the it has grown dramatically worldwide. Initial skepticism from some in the anesthesia community was overcome as its safety profile and utility became clear. Paired with international education and training programs, it achieved recognition as an essential airway management device. Some key developments in its global adoption include:

- By the 1990s it had become a standard of care in the UK and other developed nations for many surgical procedures not requiring intubation. Regional and national airway guidelines increasingly recommended its use over other supplemental oxygenation methods in appropriate cases.

- Its lower technical demand and procurement cost made it appealing for resource-limited settings. International organizations helped distribute laryngeal masks and train local clinicians in the developing world.

- The 2000s saw a proliferation of new LMATM models. Products tailored for pediatric and infant patients expanded its reach to those populations. Disposable and single-use versions cut infection risks.

- Today it is regularly stocked in hospital pharmacies, on ambulances, and other emergency contexts worldwide due to its versatility and ease of deployment even by non-anesthesia staff. This has increased patient access to safer airway management.

Global Adoption Statistics

Solid statistics on it use are difficult to obtain, but some figures indicate the remarkable extent of its worldwide dispersion:

- A 2014 study analyzing sales records estimated over 150 million LMATM devices have been sold to date across nearly 200 countries. While use remains highest in wealthier nations, shipments have greatly increased to developing regions as well.

- Surveys of anesthesia providers show it is routinely employed for many cases in every continent except Antarctica. Reported usage rates range from 30-80% of general surgical/procedural cases depending on the practice setting and country.

- Sales of the classic reusable LMATM remain strong but single-use disposable models now account for the bulk of the global market volume. Their convenience and sterility make them preferred in many health systems.

- Developing world data indicate the laryngeal mask is employed as a primary airway management strategy for millions of surgeries annually that otherwise may have been postponed due to intubation challenges or costs. This improves global surgical access.

Manufacturing and Innovation

The commercial success of the laryngeal mask has spurred growth in manufacturing of these devices worldwide to meet rising demand. Great strides have also been made across various models to enhance user experience:

- The dominant global supplier remains Intersurgical Ltd., created in 1989 and headquartered in the UK, where Dr. Brain's original patents are licensed. It produces several laryngeal mask brands at multiple international plants.

- However, numerous other medical firms now manufacture compatible 3rd-party LMATM devices approved for clinical use. Major centers of production include Europe, North America, India, China, and Indonesia.

- Advanced new versions continually debut with improved features. Examples include masks with gastric access ports, integrated bite blocks, reinforced tubes, enhanced cuffs for better seals, sizes for neonates, and devices optimized for laparoscopic or airway exchange procedures.

- Select models offer multi-oriface design for simultaneous use with nasogastric tubes or bronchoscopes. Some incorporate fiberoptic technology to aid placement verification. Developments aim to support it being used in ever more complex situations.

Future Outlook

Barring unexpected changes, laryngeal masks appear poised to maintain their prominent role in global airway management. Key factors that may influence their usage trends over the coming decades include:

- Continuing medical education efforts to optimize it techniques and expand appropriate applications based on ongoing research findings.

- Further drops in device costs as production scales up, enhancing accessibility in resource-limited settings and boosting sustained dissemination worldwide.

- Innovation of next-generation variants optimized for specific clinical contexts like resuscitation, bariatric/obese patients, or surgeries requiring longer operative times.

- Potential incorporation of more digital technology aids like integrated cameras, oxygen saturation monitoring, or disposable devices programmed with usage data.

- Integration with bundled surgical packs and procedure toolkits to facilitate "push" distribution models getting equipment where most needed, like emergency and prehospital contexts.

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About Author:

Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)