Endoscopic findings resulting from long-term intubation

Vocal cord paralysis and laryngeal injuries resulting from short-term intubation with less than 24 hours intubation time are complications well documented in the literature. The objective of this study is to examine the frequency and severity of vocal cord paralysis and laryngeal injuries after long-term intubation as well as to identify and to present potential causes. For this purpose, flexible tracheo-laryngoscopy was performed within the first 24 hours after extubation on patients with a minimum intubation period of 24 hours. A correlation of the actual intubation duration with the observed frequency and severity of laryngeal injuries and vocal cord paralysis cannot be confirmed in this study. However, the incidence of vocal cord paralysis resulting from long-term intubation as identified in this study is significantly higher than the incidence resulting from short-term intubation as documented in the literature. In the present study, vocal cord paralysis was identified in 45% of the cases (14 of 31 patients). As a possible cause of the vocal cord paralysis, the incorrect positioning of the cuff resulting in compression of the anterior branch of the recurrent laryngeal nerve between the compressed paraglottic space and the thyroid cartilage is discussed in the present study.2020-07-2