Contact Ulcer Granuloma and Other Laryngeal Complications of Endotracheal Anesthesia

Jackson, Chevalier

doi:10.1097/00000542-195309000-00001

Cited by 66 publications

(26 citation statements)

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“…This region was thought to be particularly susceptible to injury because of the fragile nature of the thin mucoperichondrium overlying the poorly vascularized cartilaginous vocal processes. 36,37 Large tube size, preexisting upper airway infection, and blind traumatic intubation have been implicated in the development of granuloma after intubation. 38 Injury from movement of the larynx against the tube has been identified as an additional risk factor.…”

Section: Mechanicalmentioning

confidence: 99%

Vocal process granuloma

et al. 2001

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Management to diminish laryngopharyngeal reflux, as well as to correct vocally abusive behavior, will appropriately address the majority of vocal process granuloma. Surgical removal is best reserved for cases when conservative management fails, when airway obstruction is a concern, or when a biopsy is needed to establish the diagnosis. Ancillary measures that may be beneficial in specific cases include the use of steroids, antibiotics, membranous vocal fold augmentation, and laryngeal botulinum neurotoxin injection.

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Section: Mechanicalmentioning

confidence: 99%

Vocal process granuloma

et al. 2001

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“…Permanent pressure of the endotracheal tube against the arytenoid leading to local ischemia and ulcération results in a progressive and extensive scarring process of various degrees of seriousness. In 1953, Chevalier Jackson 11 showed quite well that the areas most exposed to such ulcér-ation are the anterior parts of the vocal processes of the arytenoids. Exposure of the perichondrium occurs in a short time because of the thin mucosa overlying it.…”

Section: Discussionmentioning

confidence: 99%

Postintubation Interarytenoid Adhesion

Carrat¹,

Pescio²,

Verhulst³

et al. 2000

Ann Otol Rhinol Laryngol

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Interarytenoid fibrous adhesion is a poorly recognized complication of intubation and is frequently confused with bilateral vocal cord paralysis. Early diagnosis and treatment is essential for optimal management. Otolaryngologists should constantly remain alert for interarytenoid fibrous scar to establish the diagnosis as early as possible, optimizing the probability of restoring normal breathing and quality of life and avoiding an unnecessary tracheotomy. Surgical laser reduction is appropriate in all cases when other miscellaneous laryngeal injury lesions are eliminated. Direct laryngoscopy with careful examination of the posterior commissure and laryngeal electromyography are the 2 main clinical diagnostic aids contributing to establish the diagnosis.

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“…Instead, it acts as an immovable object against which the larynx will repeatedly contract in a hammer-and-anvil fashion [52]. The consequence of this laryngeal activity is the &dquo;contact ulcer&dquo; theory of laryngeal damage, adapted from observations by Jackson [53].…”

Section: Historical Developmentmentioning

confidence: 99%

“…These observations, coupled with the increasing number of case reports on laryngeal complications of TLI [52,[63][64][65][66][67][68], led many physicians to believe that prolonging TLI for more than 1 to 2 days would lead to an unacceptably high rate of serious laryngeal complications [59,69]. However, these animal and postmortem studies were incomplete because they failed to correlate laryngeal histopathology with clinical sequelae.…”

Section: Historical Developmentmentioning

confidence: 99%

Prolonged Intubation Versus Tracheostomy in the Adult

Colice

1987

J Intensive Care Med

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The development of mechanical ventilators that can en sure adequate respiration for long periods of time has led to the problem of determining how to best integrate patients into the machine's airflow circuits. Tracheal tubes with inflatable cuffs efficiently connect the patient to the machine, but the tubes may be placed in one of two ways. Each option has relative advantages and disad vantages. Translaryngeal intubation (TLI) can be per formed safety and quickly and is the preferred first step in airway management. However, when TLI is needed for prolonged periods, it may damage the larynx. Tra cheostomy, on the otherhand, has potential operative and tracheal complications, but presents little risk to the larynx and may be better tolerated by the patient requir ing long-term intubation. This review provides a histor ical background of these two methods and analyzes their respective advantages and complications. Guide lines for the optimal use of TLI and tracheostomy, par ticularly in adult patients requiring long-term intuba tion, are developed by comparing the risks and benefits of these two methods.

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Contact Ulcer Granuloma and Other Laryngeal Complications of Endotracheal Anesthesia

Cited by 66 publications

References 0 publications

Vocal process granuloma

Vocal process granuloma

Postintubation Interarytenoid Adhesion

Prolonged Intubation Versus Tracheostomy in the Adult

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