Van Zundert et al. (2016) highlight the clinical significance of supraglottic airway device (SAD) malpositioning, emphasizing its impact on ventilation efficacy and patient safety. The article outlines common malposition scenarios—such as deep or superficial placement, incorrect sizing, and cuff inflation errors—and their anatomical consequences, including epiglottic obstruction and poor seal formation. The authors advocate for preventive strategies like proper device selection, insertion technique refinement, and use of visual or fiberoptic confirmation. Corrective measures include repositioning, size adjustment, and cuff pressure optimization. Their concise review underscores the need for vigilance and structured protocols to minimize SAD-related complications during anesthesia.

Van Zundert AA, Kumar CM, Van Zundert TC. Malpositioning of supraglottic airway devices: preventive and corrective strategies. Br J Anaesth. 2016 May;116(5):579-82. doi: 10.1093/bja/aew104. PMID: 27106958.