Laryngotracheal injury following endotracheal intubation has been extensively described in the literature, but most discussion has centered around the sequela of prolonged intubation. Little however, has been reported regarding the lesions from
short-term endotracheal intubation to ensure the safe practice of anesthesia.
In this regard, 72 healthy, male patients undergoing undergoing general anesthesia for surgical procedures were randomly assigned to have an endotracheal tube of 7.0, 8.0, or 9.0 mm in diameter and were evaluated for the upper airway symptoms by
questionnaire within 4-8 hours following extubation. The larynx and trachea were examined and scored for extent and severity of laryngotracheal damage by fiberoptic laryngotracheoscopy, and risk factors causing laryngotracheal injury were
studied.
@ES The results were as follows:
@EN The incidence of upper airway symptoms were 13 of 72 (18.1%) or which 10 (13.9%) were throat discomfort and 3 (4.2%) were sore throat.
The incidence of laryngeal and tracheal injury was 52 of 72 (72.2%) and 20 of 72 (27.8%), respectively. 20 patients (27.8%) did not reveal any lesion in the lafryngotracheal system. The common sites of intubation injury were vocal cords (65.3%,
all
erythema) and arytenoids (44.4%, erythema 37.5%, edema 6.9%).
No correlation could be drawn between the injured and uninjured groups wity respect to smoking and length of intubation. However, bucking was associated with severity and extent of laryngeal damage (p<0.05), and with the extent of tracheal damage
only
(p<0.05). Also, the increase in internal diameter of the tube used was associated with severity and extent of laryngeal damage (p<0.05), but not with tracheal damage.
|