Secondary Logo

Journal Logo


Ear's looking at you kid…

Allen, Laurin; Engelhardt, Thomas

Author Information
European Journal of Anaesthesiology: May 2013 - Volume 30 - Issue 5 - p 260
doi: 10.1097/EJA.0b013e32835f99d2


We read with interest the article of Zahoor et al.1 on a novel method for laryngeal mask airway size selection in paediatric patients, which will undoubtedly prove useful for the occasional paediatric anaesthetist.

Laryngeal mask airways have been used in paediatric practice for more than 30 years and the size guide recommended by the manufacturers has remained unchanged. This study not only demonstrated the fact that using a patients’ ear size resulted in a well fitting laryngeal mask airway the majority of the time, but also that in a large percentage of cases, this was a smaller laryngeal mask airway than perhaps would have been initially chosen otherwise.

Although using this method for choosing a laryngeal mask airway could be considered perfectly acceptable, perhaps it is time to look at the original sizing recommendations. In today's society, is a child's weight really an accurate guide to the size of its supraglottic airway anatomy? Perhaps, a study looking at length/height is needed.

The manufacturers need to reconsider the marking of weight ranges on laryngeal mask airways and instead mark age ranges on these products. Until such time, this simple ear test provides an elegant and quick solution to a common problem for the inexperienced care provider.


Assistance with the letter: none declared.

Financial support and sponsorship: none declared.

Conflicts of interest: none declared.

Comment from the Editor: Dr Zahoor and colleagues did not respond to the editor's invitation to reply to this letter.


1. Zahoor A, Ahmad N, Sereche G, et al. A novel method for laryngeal mask airway selection in paediatric patients. Eur J Anaesthesiol 2012; 29:386–390.
© 2013 European Society of Anaesthesiology