The Annals of otology, rhinology, and laryngology
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Ann. Otol. Rhinol. Laryngol. · Aug 2018
ReviewProlonged Intubation Injuries of the Larynx: Endoscopic Diagnosis, Classification, And Treatment.
Laryngeal trauma from prolonged endotracheal intubation occurs in patients of all ages. Most changes are superficial and heal quickly. ⋯ This classification has required introduction of new descriptive terminology: "tongues of granulation tissue," "ulcerated troughs," "healed furrows," and "healed fibrous nodule." During intubation the degree of injury can be precisely assessed under general anesthesia by using telescopes for image magnification, thus assisting adecision whether to continue intubation orperform tracheotomy to minimize long-term morbidity. Changes that are found after extubation result from granulation tissue, ulceration, ora combination of both and have been illustrated on flow charts; a knowledge and understanding of these sequelae allows them to be identified by both indirect and direct laryngoscopy so that treatment can be planned.