I would like to thank Dr. Alfrey for his positive feedback about my proposed classification system1and for correctly pointing out that the PLA  in CobraPLA ™(Engineered Medical Systems, Indianapolis, IN) stands for perilaryngeal airway  rather than pharyngeal lumen airway . Dr. Alfrey states that the rationale behind the term perilaryngeal  is that the CobraPLA™ head abuts against the aryepiglottic folds near the laryngeal inlet. Perhaps periaryepiglottic  would have been a more accurate term, making it the CobraPAA. Interestingly, the use of the prefix peri - in this instance is used to mean “near” rather than “around,” because the CobraPLA™ does not form a seal around the larynx, unlike the Laryngeal Mask Airway® (Laryngeal Mask Company Limited, San Diego, CA).

Finally, to the list of modern extraglottic airway devices given in my original proposal1must be added several new products: the Elisha airway device (Elisha Medical Technologies, Katzrin, Israel); disposable versions of the flexible and intubating laryngeal mask airway (Laryngeal Mask Company, San Diego, CA); several disposable laryngeal mask airway–like devices; a modified esophageal tracheal Combitube (Kendall Sheridan Catheter Corporation, Argyle, NY); and the C-Trach® (Laryngeal Mask Company, San Diego, CA), an intubating laryngeal mask airway with built-in fiberoptics and a viewing screen. Many new extraglottic airway devices will make their debuts in the near future; few will stand the test of time. There is no doubt that none will have a name quite as troublesome as the CobraPLA™, at least for those among us with snake phobias.

James Cook University, Cairns Base Hospital, Cairns, Australia. jbrimaco@bigpond.net.au

Brimacombe J: A proposed classification system for extraglottic airway devices (letter). Anesthesiology 2004; 101:559