Management of infant laryngeal disorders in relation to wound healing processes of the rabbit larynx.
Laryngotracheal injury caused by prolonged intubation is mostly treated by reintubation or surgical intervention. To understand the histopathological processes involved in wound healing of laryngeal trauma and to assess the value of reintubation as treatment for post-intubation injury, the findings of a study in preterm infants were placed next to the results of experimental studies on laryngeal disorders in young, growing rabbits. Observations at laryngobronchoscopy in the child are compared to histopathological investigations in the animal. In both series various, evidently similar categories of injury could be distinguished viz. edema, ulcerations and granulations. The results of treatment like reintubation would vary with the diagnosed category of the injury; the more granulation tissue, the less successful conservative treatment will be. It is concluded that histopathologic classification is essential for good management of intubation injuries and that therapeutic re-intubation in case of superficial lesions should precede the decision for surgery.
Department of Otorhinolaryngology, Erasmus University Rotterdam, The Netherlands.
H L
HL
Verwoerd-Verhoef
L J
LJ
Hoeve
J K
JK
Bean
C D
CD
Verwoerd
D000818:Animals; D006102:Granuloma, Laryngeal / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007819:Laryngeal Edema / Q000503:physiopathology / Q000628:therapy; D007830:Larynx / Q000293:injuries*; D011817:Rabbits; D014945:Wound Healing