To the Editor:—

The apparatus described by Dr. Balatbat et al.  1for applying lidocaine to the airway bears an uncanny resemblance to an arrangement that I first described in 1998. 2I do appreciate, however, that it is not always easy to identify instances of previous publication, even with the most assiduous of literature searches, particularly if the publication in question happens to be correspondence. I say this with confidence because I made the same error myself; the arrangement was originally described by Dr. Tran in 1992. 3Although others have judged my apparatus to be “more simple and ingenious” than that described by Dr Tran, 4I suspect the same cannot be said for the arrangement described by Dr. Balatbat.

Whatever the merits of the various descriptions, it is worth emphasizing that the Tran-Mackenzie-Balatbat spray is a simple, elegant, and effective method for the topical application of drug sprays to mucosa-lined cavities, and is frequently adopted by those who have seen it in action, including otorhinolaryngologists.

Balatbat JT, Stocking JE, Rigor BM: Controlled intermittent aerosolization of lidocaine for airway anesthesia. A NESTHESIOLOGY 1999; 91:596
Mackenzie I: A new method of drug application to the nasal passage. Anaesthesia 1998; 53:309–10
Tran DQ: A simple device for administration of topical anesthesia to the upper airway. Anesth Analg 1992; 74:620–1
Bucx MJL: Application of drugs to the nasal passages. Anaesthesia 1998; 53:722–3