Short-Term Effects of Endotracheal Intubation on Voice

Hamdan, Abdul‐Latif; Sibai, Abla Mehio; Rameh, Charbel; Kanazeh, Ghassan

doi:10.1016/j.jvoice.2006.06.003

Cited by 46 publications

(47 citation statements)

References 25 publications

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“…48 After being extubated, many patients have transient complaints of vocal fatigue, dysphagia, sore throat, hoarseness, throat clearing, and aspiration. Hamdan et al 50 studied the short-term effects of intubation on voice and found that the most important variables associated with an increase in vocal symptoms were mean cuff pressure and volume. Patients with persistent vocal fatigue had higher mean cuff volumes than did patients without that symptom, and persistent throat clearing was more prevalent in patients with higher mean cuff pressures.…”

Section: Larynxmentioning

confidence: 99%

“…Patients with persistent vocal fatigue had higher mean cuff volumes than did patients without that symptom, and persistent throat clearing was more prevalent in patients with higher mean cuff pressures. 50 However, Hamdan et al 50 also documented that most of these symptoms resolved within 24 h. When symptoms persist or progress, the presence of more serious injuries, such as vocal fold lacerations, hematomas, or avulsion, must be considered because these injuries usually take longer to heal and could potentially lead to poor voice outcomes, prolonged voice problems, and vocal fold scarring. 51 In a survey of patients regarding postintubation dysphonia, 49% of patients stated that they had vocal difficulty on the day of surgery, but the symptoms improved over time, with 29, 11, and 0.8% stating that dysphonia was present on postoperative days 1, 3, and 7, respectively.…”

Section: Larynxmentioning

confidence: 99%

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Complications of Airway ManagementDiscussion

Pacheco-Lopez¹,

Berkow

Hillel³

et al. 2014

Respir Care

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Although endotracheal intubation is commonly performed in the hospital setting, it is not without risk. In this article, we review the impact of endotracheal intubation on airway injury by describing the acute and long-term sequelae of each of the most commonly injured anatomic sites along the respiratory tract, including the nasal cavity, oral cavity, oropharynx, larynx, and trachea. Injuries covered include nasoseptal injury, tongue injury, dental injury, mucosal lacerations, vocal cord immobility, and laryngotracheal stenosis, as well as tracheomalacia, tracheoinnominate, and tracheoesophageal fistulas. We discuss the proposed mechanisms of tissue damage that relate to each and present their most common clinical manifestations, along with their respective diagnostic and management options. This article also includes a review of complications of airway management pertaining to video laryngoscopy and supraglottic airway devices. Finally, potential strategies to prevent intubation-associated injuries are outlined.

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Section: Larynxmentioning

confidence: 99%

Section: Larynxmentioning

confidence: 99%

Complications of Airway ManagementDiscussion

Pacheco-Lopez¹,

Berkow

Hillel³

et al. 2014

Respir Care

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“…After 24 hours, the percent of the patients decreased but remained significantly higher; hoarseness and throat clearing were dominant, throat pain (40.8%) caused more discomfort than globus pharyngeus (24.3%) ( Table 1). The percent of complaints in 2 hours after extubation was slightly lower in Hamdan's study of 35 patients (13). The dominant symptoms were as follows: throat pain (52.9%), aphonia (50.0%), throat clearing (38.2%), vocal fatigue (35.3%).…”

Section: Discussionmentioning

confidence: 63%

“…When the volume of the cuff increases, the contact area of the cuff and trachea increases as well, mucosal perfusion worsens because of increase in the pressure of the contact area, especially if the cuff pressure exceeds the pressure of perfusion of tracheal capillaries (>39 cmH 2 O or >30 mmHg), consequently causing mucosal ischemia, edema and necrosis (13,20). Thus, the recommended safe tube cuff pressure should not exceed 26 cmH 2 O or 20 mmHg (21).…”

Section: Discussionmentioning

confidence: 99%

Laryngopharyngeal complaints following short-term endotracheal intubation: peculiarities of males and females

Paulauskienė¹,

Lesinskas²

2012

AML

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Background. Laryngopharyngeal complaints are classified as minor post-intubation complications. They cause great discomfort, have some influence on the quality of life and can limit patient's casual activity. The extent of complaints ranges from 12 to 65%. Undesirable complications can be avoided by ascertaining factors that are able to provoke or decrease laryngopharyngeal symptoms after endotracheal intubation. In this study, we assessed predominant laryngopharyngeal symptoms following a short-term endotracheal intubation and their peculiarities subject to gender, and we estimated the most important influencing factors.Materials and methods. 218 patients were examined before endotracheal anesthesia, 1-2 and 24 hours after extubation. The following laryngopharyngeal complaints were recorded: hoarseness, vocal fatigue, globus pharyngeus, throat pain and throat clearing. These factors were also assessed in relation to endotracheal intubation parameters: endotracheal tube size, cuff volume and pressure, number of intubation attempts, length of anesthesia, experience of anesthesiologist and additional parameters: smoking, allergy, GERD symptoms, laryngitis and singing skills subject to gender.Results. All laryngopharyngeal symptoms increased significantly in 2 hours after extubation and remained increased after 24 hours in both male and female groups. In 1-2 hours after extubation, females complained of throat pain more than males (61.3 vs. 42.9%; p = 0,014). The following significant relations were found 1-2 hours after extubation: between throat pain and length of anesthesia, globus pharyngeus and tube size and cuff volume in the male group; between globus pharyngeus, vocal fatigue and smoking, throat clearing and cuff volume in the female group. After 24 hours, the relation was noticed between vocal fatigue and cuff volume and number of intubation attempts, globus pharyngeus and length of anesthesia, between hoarseness and number of intubation attempts and between throat pain and singing skills in the male group. Some relation between throat clearing and cuff volume remained for 24 hours after extubation, smoking had influence on hoarseness and vocal fatigue in the female group.Conclusions. Laryngopharyngeal symptoms remain an important cause of discomfort for 24 hours after extubation. Females complain of laryngeal and pharyngeal symptoms more than males and throat pain following extubation is also more frequent in females. The most important parameters of short-term endotracheal intubation that influence laryngopharyngeal complaints are as follows: cuff volume, length of anesthesia and number of intubation attempts that affect males more than females. Smoking affects females more, though singing skills are more significant in the male group.

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“…Studies comparing high flow nasal cannula oxygen delivery and conventional oxygen with face masks should also evaluate laryngeal function. This might be accomplished by voice assessment and ultrasound measurements (14)(15)(16). The termination of high flow nasal cannula oxygenation support should be based on clinical parameters and not arbitrary time limits.…”

Section: Discussionmentioning

confidence: 99%

Postextubation management of patients at high risk for reintubation

Nugent¹

2016

J. Thorac. Dis.

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Short-Term Effects of Endotracheal Intubation on Voice

Cited by 46 publications

References 25 publications

Complications of Airway ManagementDiscussion

Complications of Airway ManagementDiscussion

Laryngopharyngeal complaints following short-term endotracheal intubation: peculiarities of males and females

Postextubation management of patients at high risk for reintubation

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