title: Endoscopic evolution of laryngeal injuries caused by translaryngeal intubation.
abstract: Despite improvements in tube design and materials, the longer survival rates of critically ill patients make laryngeal and tracheal lesions still common following prolonged translaryngeal intubation. The time of intubation is almost the only factor employed in deciding whether or not tracheotomy has to be performed. Some patients will not develop laryngeal lesions afer long intubation periods, whereas some already have clinical symptoms after short periods of time. If the conditions of the larynx and trachea could be assessed before irreversible complications take place, then timing of tracheotomy could be individualized to avoid laryngeal stenosis as well as unnecessary tracheostomies. We present the preliminary results of an endoscopic study of the early laryngeal changes that take place during translaryngeal intubation. The method of exploration is explained and tissue changes seen and their evolution after extubation are described, emphasizing those that could have a predictive value.
authors.affiliation: Department of Otorhinolaryngology, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Vila
authors.forename: M D
authors.initials: MD
authors.lastname: Bosque
authors.forename: M
authors.initials: M
authors.lastname: García
authors.forename: M
authors.initials: M
authors.lastname: Palomar
authors.forename: P
authors.initials: P
authors.lastname: Quesada
authors.forename: B
authors.initials: B
authors.lastname: Ramis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D016638:Critical Illness; D004487:Edema / Q000209:etiology / Q000473:pathology; D004867:Equipment Design; D004890:Erythema / Q000209:etiology / Q000473:pathology; D005260:Female; D006099:Granuloma / Q000209:etiology / Q000473:pathology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation; D007818:Laryngeal Diseases / Q000209:etiology / Q000473:pathology; D007828:Laryngoscopy; D007829:Laryngostenosis / Q000517:prevention & control; D007830:Larynx / Q000293:injuries* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012680:Sensitivity and Specificity; D015996:Survival Rate; D013997:Time Factors; D014132:Trachea / Q000293:injuries / Q000473:pathology; D014133:Tracheal Diseases / Q000209:etiology / Q000473:pathology; D014139:Tracheostomy; D014140:Tracheotomy
chemical_list: D001672:Biocompatible Materials