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To the Editor:—
The recent letter (195:47, 1966) in response to the editorial "Tonsillectomy Mortality" (194:824, 1965) shed little light on the problem and if anything was harmful to medicine, particularly to the speciality of anesthesiology.Some of the arguments of the writer may be valid, but the reference given does not substantiate them in fact.For a tonsillectomy, an adequate airway can be maintained with or without an endotracheal tube. It is more difficult to do so without an endotracheal tube. Careful attention must be paid to premedication (with emphasis on absence of depressant drugs), type of anesthetic agent, gas flows, use or nonuse of diluent gases and flows, only to name a few of the relevant factors to be considered when one is using the insufflation or nonendotrachealtube technique.An endotracheal tube for a tonsillectomy does not per se guarantee an adequate airway. Careful attention must
Westmont RW. Tonsillectomy Mortality. JAMA. 1966;195(9):788. doi:10.1001/jama.1966.03100090122037