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This study reviews the physiology, physics, and problems of each anesthetic technique. In light of this review, animal and human studies are reported demonstrating the utility and safety of subglottic ventilation when provided with proper monitoring using an automatic ventilator. A modified Ben\u2010Jet tube is reported,<jats:sup>5<\/jats:sup> which has a 1\u2010mm ID channel to monitor Pco<jats:sub>2<\/jats:sub> and tracheal pressure. This self\u2010centering 3.0\u2010mm tube, which extends 6 to 8 cm below the glottis, is unobtrusive for the surgeon. The subglottic tube, which is much less likely to be malaligned, is much more acceptable to the anesthesiologist. Anesthesia, by intravenous sedation, utilizes neuromuscular blockade while ventilating through the jet tube powered by an automatic ventilator with an automatic shutdown feature attached to the monitor tube to prevent inadvertent barotrauma.<\/jats:p><jats:p>The third phase of this study compared fluoroplastic, used in a prototype jet ventilation tube, with 6\u2010mm Silastic\u00ae, Red Rubber, and polyvinyl chloride (PVC) tubes when struck by maximum power of CO<jats:sub>2<\/jats:sub>, Nd\u2010YAG, and K\u2010532 lasers. The test was performed in a closed chamber in which concentrations of oxygen and nitrogen were controlled. Although damaged by the CO, laser beam, the fluoroplastic tubes did not continue burning when the laser was turned off in 100% oxygen, even when coated by blood. The other three tubes continued to burn in 23% oxygen. Neither the KTP nor Nd\u2010YAG laser damaged the Teflon tube, while they ignited a sustained flame in 30% oxygen.<\/jats:p><jats:p>This study supports the use of fluoroplastic for a laser safe jet ventilation tube. It also demonstrates the danger of tube fires, even in low oxygen concentrations, when using Silastic, rubber, and PVC tubes in laser laryngeal surgery. There was no difference in the flammability of Silastic, rubber or PVC when struck by these lasers in this study.<\/jats:p><jats:p>For these reasons, subglottic ventilation using a fluoroplastic, monitored, self\u2010centering, subglottic, jet ventilation tube driven by an automatic ventilator with a shutdown feature, in the event of excessive pressure buildup, is proposed for anesthetizing healthy patients undergoing suspension microlaryngoscopy, and who have no airway obstructing lesion. A large tube with inflatable cuff is indicated when a supraglottic lesion may obstruct the airway.<\/jats:p>","DOI":"10.1002\/lary.1994.104.s65.1","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T14:27:31Z","timestamp":1488205651000},"page":"1-30","source":"Crossref","is-referenced-by-count":82,"title":["Anesthesia for Microlaryngeal Surgery: The Case for Subglottic Jet Ventilation"],"prefix":"10.1002","volume":"104","author":[{"given":"Darrell H.","family":"Hunsaker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,1,4]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348946006900421"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1970.00770040266019"},{"key":"e_1_2_1_4_1","volume-title":"Microlaryngoscopy and Endolaryngeal Microsurgery","author":"Kleinsasser 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