Changes in the cricoarytenoid joint induced by intubation in neonates.
OBJECTIVE
To characterize the histopathologic characteristics of the cricoarytenoid joint (CAJ) as a means to understand the mechanisms of vocal cord fixation in children after prolonged intubation.


METHODS
Histologic analysis of laryngeal specimens obtained from infants who had died secondary to various causes and who had been intubated from 1 to 30 days.


METHODS
Histopathologic characteristics of CAJ.


RESULTS
Laryngeal specimens from infants who had been intubated for prolonged periods of time demonstrated evidence of hemorrhage, infection, inflammation, and fibrosis within the CAJ. Furthermore, a statistical correlation was found between the length of intubation and the presence of these histologic abnormalities.


CONCLUSIONS
To our knowledge, this is the first study to demonstrate histologic changes in the CAJ in laryngeal specimens of children who have been intubated for prolonged periods of time. Such histological changes in the CAJ could explain the mechanism of vocal cord immobility in children after intubation.
Vijayasekaran
Shyan
S
Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
Sances
Richard
R
Cotton
Robin
R
Elluru
Ravindhra G
RG
D001193:Arytenoid Cartilage / Q000293:injuries* / Q000473:pathology; D003413:Cricoid Cartilage / Q000293:injuries* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007818:Laryngeal Diseases / Q000209:etiology / Q000473:pathology*; D008297:Male; D012720:Severity of Illness Index; D013997:Time Factors