title: Retrospective analysis of the clinical course for intubation vs. unspecified laryngeal granulomas.
abstract: Intubation laryngeal granulomas (ILGs) are a well-known complication of endotracheal intubation. Cases other than ILGs can be categorized as unspecified laryngeal granulomas (ULGs) since their etiologies are often difficult to confirm. We intended to clarify clinical features of both ILGs and ULGs and that anticoagulant medication could cause the formation and delayed healing of ILGs in terms of wound-healing delay. We compared the results of our treatment of ILGs (n = 16) and ULGs (n = 47) treated between 1998 and 2009 to characterize these patients. The clinical course, treatment (medical vs. surgical), indications for surgical resection, treatment outcome, and use of anticoagulants for preexisting disease were reviewed and compared between these two groups. The resolution rate was significantly better in ILGs (p < .05). Five ILGs and seven ULGs were surgically resected. The main reason for resection was airway obstruction and the need for histological assessment, respectively. The use of anticoagulants was significantly higher in ILGs than ULGs (8/16 vs. 4/47, p < .01). The resolution period was significantly longer in the ILGs patients with anticoagulant medication compared to that in the ILGs patients without anticoagulant medication (152 ± 101 days vs. 76 ± 44 days, p < .05). ILGs may have different clinical course from ULGs, especially in terms of the resolution period. Moreover, administration of anticoagulants may deter healing of small injury due to intubation. Patients taking anticoagulants should be managed carefully during the perioperative period to prevent the occurrence of ILGs.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kumai
authors.forename: Eiji
authors.initials: E
authors.lastname: Yumoto
authors.forename: Kohei
authors.initials: K
authors.lastname: Nishimoto
authors.forename: Ryosei
authors.initials: R
authors.lastname: Minoda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000139:chemically induced / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006102:Granuloma, Laryngeal / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014945:Wound Healing / Q000187:drug effects; D055815:Young Adult
chemical_list: D000925:Anticoagulants