The correlation between morphological and functional laryngeal changes and the parameters of short−term endotracheal intubation Biomedical Sciences, Medicine (06B)

Modern endotracheal anesthesia is relatively a safe procedure; however its effect on laryngeal morphology and function is still very significant. Complicated intubation amounts just over one third of all complicated cases, thus the majority of lesions appear during casual procedures or after them and the frequency of long−term hoarseness after intubation shows the relevance of postintubational complications. The aim of the study was to notice and evaluate primary laryngeal functional and morphological changes following short−term endotracheal intubation for patients, who had no laryngeal pathology before intubation; and to evaluate the correlation between these changes to parameters of intubation and experience of an anesthesiologist. The scientific work included 201 patients who were treated at the ENT Centre of Vilnius University Hospital Santariskiu Klinikos since 2009 till 2012. All the patients underwent scheduled operations under general anaesthesia and were examined on the day of the surgery prior endotracheal intubation, 1−2 hours and 24 hours after extubation. The vocal and pharyngeal symptoms were evaluated, acoustic analysis of voice and speech, aerodynamic examination of voice, videolaryngoscopy and videostroboscopy were performed and morphological and functional laryngeal lesions were assessed. The following parameters of endotracheal anesthesia were recorded: duration of intubation, number of intubation attempts, size of the tube, cuff volume and pressure and the experience of an anesthesiologist. This is the first prospective study that properly evaluated correlation between the short−term endotracheal intubation and morphological and functional laryngeal changes following extubation during early postextubational period (1−2 hours after extubation) and one day after. The main parameters of endotracheal anesthesia, that cause postextubational morphological and functional laryngeal changes were assessed; primary morphological laryngeal changes and stroboscopic findings were evaluated just after extubation and one day after; as well as the correlation between these lesions and main vocal acoustic characteristics. Examination of the morphological and functional laryngeal changes following extubation enables the awareness of principles in laryngeal functionality after intervention, improves the quality of diagnostics and prevention of postextubational complications