الفهرس 
TYPES OF INTUBATION INJURYOnly 14 pages are availabe for public view
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Abstract
Endotracheal intubation for general anaesthesia and mechanical ventilation can be a source of local trauma.
There are many Types of laryngeal injury caused by intubation as vocal fold edema, erythema, ulceration, paralysis/paresis/bowing of the vocal cords, laryngeal scar, fibrosis, granuloma formation, glottic webs, superior-laryngeal nerve paralysis, pneumonia, atelectasis and hoarseness.
Long-term complications of endotracheal intubation as Hoarseness, Paranasal sinusitis, Vocal cord paralysis, Arytenoid subluxation, vocal cord granuloma, Laryngotracheal stenosis, and Tracheobronchomalacia.
Causes of laryngeal injury due to intubation are not fully understood. Many studies found that 97% of subjects had some form of laryngeal injury, ranging from mild edema to granuloma to vocal fold immobility, and that the associated risks were duration of intubation and presence of a nasogastric tube. They observed a 20% rate of vocal cord immobility that was associated with the duration of intubation and the size of the endotracheal tube (ETT).
Other studies found that the laryngeal findings correlated only to presence of neuromotor activity and performance of a
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Conclusion
tracheostomy, not to the duration of intubation or size of endotracheal tube. Numerous reports indicate that tracheal tube damage may be influenced by the cuff pressure and duration of cuff inflation, together with movement of the tracheal tube during respiration.
• Many tests and investigations are done to diagnose laryngeal
injury as cuff leak test , Flexible nasopharyngoscopy,
Videostrobolaryngoscopy, Objective voice measurements,
Electromyography, Speech therapy evaluation.
• Prevention of laryngeal edema, and thereby decreasing the
incidence of extubation failure, is obviously desirable. The
strategies for laryngeal edema prevention will now be discussed.
• First, considering tube size as a risk factor, intubation with a 7
or 7.5 mm tube in males and a 6.5 mm tube in females would
be desirable. A reduced endotracheal tube diameter, however,
may delay weaning, potentially interfere with bronchoscopic
procedures and will increase ventilatory resistance, making the
use of smaller tube sizes not feasible.
• Also, several studies have reported the effect of corticosteroids
in preventing post-extubation laryngeal edema. Finally, early