Acquired Oral Commissure Defect: A Complication of Prolonged Endotracheal Intubation

Kahn, Doron J.; Spinazzola, Regina

doi:10.1038/sj.jp.7211354

Cited by 6 publications

(6 citation statements)

References 19 publications

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“…This case illustrates an important clinical feature of upper lip PU arising from endotracheal tube tension in a preterm neonate. In the two published cases on neonatal PU due to endotracheal tube tension, PU occurred at 28–72 days after birth . The neonates in these cases were born at <29 weeks of gestation and had very low‐birthweight (<1200 g).…”

Section: Discussionmentioning

confidence: 99%

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Early upper lip pressure ulcer in a preterm neonate

Makimoto

Kawasaki

Inomata

et al. 2017

Pediatrics International

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Section: Discussionmentioning

confidence: 99%

“…Elastic tape, which is flexible but has strong tension, is used for fixation in the present NICU, but this strong tension may be associated with the development of PU. Kahn and Spinazzola reported that routine use of endotracheal tube holder can protect the lip from pressure …”

Section: Discussionmentioning

confidence: 99%

Early upper lip pressure ulcer in a preterm neonate

Makimoto

Kawasaki

Inomata

et al. 2017

Pediatrics International

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“…On day 72 after a 3.5-mm endotracheal tube (ETT) intubation, a circular lesion was discovered on the left side of the mouth while replacing the ETT holder. The lesion, which occurred in the oral commissure area, was clean and smooth, without active bleeding, with minimal reactive inflammation [22].…”

Section: Acquired Oral Commissure Defectmentioning

confidence: 99%

“…Various complications of orotracheal intubation in infants have been documented in the literature (Tables 1 and 2), including acute [13141516] and chronic trauma [17] to the hypopharyngeal structures, systemic [181920], and local [21] side effects, and deleterious effects on oral development [22232425]. Delayed eruption, ectopic impaction, and tooth malformation following orotracheal intubation are reportedly caused by displacement and localized trauma to the tooth germ [42627].…”

Section: Introductionmentioning

confidence: 99%

Dental complications associated with neonatal intubation in preterm infants

Kim

Kang

Song

et al. 2019

J Dent Anesth Pain Med

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This paper describes the potential oral complications in preterm infants who have undergone orotracheal intubation. Neonatal intubation may have adverse effects on the developing deciduous teeth, oral soft tissues, and even the permanent teeth. However, endotracheal intubation may be essential for the survival of premature infants, owing to incomplete tracheal development. Excessive pressure to the oral tissue must be avoided, in cases where orotracheal intubation is inevitable. Moreover, the potential oral complications must be considered when neonatal intubation is performed for the patient's survival, and subsequent reevaluation and proper oral health care are needed.

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“…These complications may occur throughout the respiratory system locally as apnea, oropharyngeal aspiration, atelectasis, pneumothorax, pneumonia, vocal cord edema and perforation, granuloma formation, subglottic stenosis, tracheitis, and hemorrhage. Hypoxia, bradycardia, hypertension, and infection are systemic complications related to OTI 4‐6 . Specifically, the OTI may cause detrimental effects on oral development during the acute phase or later by damaging the alveolar crest and developing tooth germs in the anterior region 7 .…”

Section: Introductionmentioning

confidence: 99%

Knowledge, behavior, and awareness of neonatologists and anesthesiologists about oral complications of intubation and protection methods

Pamukçu

Dal

Altuntaş

et al. 2020

International Dental Journal

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Objectives: This study aimed to assess awareness of anesthesiologists and neonatologists about oral complications occurring during and after the orotracheal intubation (OTI) in premature infants and their knowledge and behavior regarding protection methods from these complications in clinical practice. Methods: This study included 94 neonatologists and 137 anesthesiologist. The final version of the questionnaire included 15 items in three main parts: (i) personal information; (ii) awareness about oral complications occurring during and after the OTI in premature infants; (iii) knowledge and behavior regarding protection methods from these complications in clinical practice. Results: A total of 95.7% of neonatologists and 83.2% of anesthesiologists were aware of oral complications related to OTI. The most common complications the anesthesiologists encountered were oral, laryngeal, or pharyngeal region injuries (60.7%) and palatal groove (52.2%) for the neonatologists. The most preferred method for stabilization of the orotracheal intubation tube (OTT) was bonding to the perioral region with an adhesive tape (98.3%). The primary determining factor in the choice of OTT stabilization method was the ease of use (28.2%). A total of 23.8% of the participants were aware of the palatal stabilization device (PSD), whereas only 1.3% used it in their routine and 57.1% of them believed it can prevent complications. Conclusions: The results showed that neonatologists were more aware of the OTI-related oral complications than anesthesiologists. The knowledge of the participants regarding prevention of these complications is insufficient. Study participants believe in the efficacy of PSD but do not use it in clinical practice for a number of reasons.

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Acquired Oral Commissure Defect: A Complication of Prolonged Endotracheal Intubation

Abstract: A number of complications during and following endotracheal intubation of infants are well described in the literature. We describe a rare case of an oral commissure defect acquired from prolonged endotracheal intubation in a ventilator-dependent preterm infant.

Cited by 6 publications

References 19 publications

Early upper lip pressure ulcer in a preterm neonate

Early upper lip pressure ulcer in a preterm neonate

Dental complications associated with neonatal intubation in preterm infants

Knowledge, behavior, and awareness of neonatologists and anesthesiologists about oral complications of intubation and protection methods

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