Dursun Mehmet Mehel1, Doğukan Özdemir2, Mehmet Çelebi2, Samet Aydemir2, Gökhan Akgül2, Abdulkadir Özgür2. 1. University of Health Sciences-Samsun Health Practices and Research Center, Department of Otorhinolaryngology, Samsun, Turkey. Electronic address: doktormehel@gmail.com. 2. University of Health Sciences-Samsun Health Practices and Research Center, Department of Otorhinolaryngology, Samsun, Turkey.
Abstract
OBJECTIVE: This study aims to evaluate injuries occurring in the larynx of patients intubated in intensive care units for a long time. STUDY DESIGN: Prospective clinical study. SETTING: Tertiary hospital. SUBJECT AND METHODS: Between April 15, 2019, and November 15, 2019, 40 patients who were hospitalized in intensive care units had a tracheotomy procedure due to prolonged intubation, and laryngeal structures were evaluated by direct laryngoscopy. The laryngeal structures were evaluated in four groups as glottic-supraglottic region, arytenoid vocal process, interaritenoid region and subglottic region. Edema, granulation and ulceration findings in these four regions were recorded. The injuries to the laryngeal structures were classified as stages 0-3. As a result of the data obtained, the relationship between the degree of laryngeal lesions and the factors that may cause these lesions was investigated. RESULTS: According to our classification, nine patients had stage 1, 16 patients had stage 2 and 15 patients had stage 3 laryngeal injury. There was no significant relationship between the stage of laryngeal injury and age, sex and diameter of the intubation tube. There was a statistically significant relationship between laryngeal injury and the day the tracheotomy was performed (p = 0.007). CONCLUSION: In patients that had prolonged endotracheal intubation, injury to the laryngeal structures is inevitable. To minimize this occurrence, tracheotomy should be performed for intubations that extend for more than seven days. When performing the tracheotomy, the laryngeal structures should be evaluated, necessary precautions should be taken for the traumatic lesions that are difficult to heal, and treatment should be started.
OBJECTIVE: This study aims to evaluate injuries occurring in the larynx of patients intubated in intensive care units for a long time. STUDY DESIGN: Prospective clinical study. SETTING: Tertiary hospital. SUBJECT AND METHODS: Between April 15, 2019, and November 15, 2019, 40 patients who were hospitalized in intensive care units had a tracheotomy procedure due to prolonged intubation, and laryngeal structures were evaluated by direct laryngoscopy. The laryngeal structures were evaluated in four groups as glottic-supraglottic region, arytenoid vocal process, interaritenoid region and subglottic region. Edema, granulation and ulceration findings in these four regions were recorded. The injuries to the laryngeal structures were classified as stages 0-3. As a result of the data obtained, the relationship between the degree of laryngeal lesions and the factors that may cause these lesions was investigated. RESULTS: According to our classification, nine patients had stage 1, 16 patients had stage 2 and 15 patients had stage 3 laryngeal injury. There was no significant relationship between the stage of laryngeal injury and age, sex and diameter of the intubation tube. There was a statistically significant relationship between laryngeal injury and the day the tracheotomy was performed (p = 0.007). CONCLUSION: In patients that had prolonged endotracheal intubation, injury to the laryngeal structures is inevitable. To minimize this occurrence, tracheotomy should be performed for intubations that extend for more than seven days. When performing the tracheotomy, the laryngeal structures should be evaluated, necessary precautions should be taken for the traumatic lesions that are difficult to heal, and treatment should be started.
Authors: Cesare Piazza; Marta Filauro; Frederik G Dikkers; S A Reza Nouraei; Kishore Sandu; Christian Sittel; Milan R Amin; Guillermo Campos; Hans E Eckel; Giorgio Peretti Journal: Eur Arch Otorhinolaryngol Date: 2020-06-06 Impact factor: 2.503
Authors: Brett A Miles; Bradley Schiff; Ian Ganly; Thomas Ow; Erik Cohen; Eric Genden; Bruce Culliney; Bhoomi Mehrotra; Steven Savona; Richard J Wong; Missak Haigentz; Salvatore Caruana; Babak Givi; Kepal Patel; Kenneth Hu Journal: Head Neck Date: 2020-04-20 Impact factor: 3.147