Advances in medical treatment have led to an increase in the number of patients requiring
intensive care and airway support. Along with this increase has grown the recognition
that significant short- and long-term morbidity may be associated with the use of
artificial airways [
1
,
2
,
3
,
4
]. Despite significant improvements in the biocompatibility of materials used in translaryngeal
tubes and efforts to decrease the trauma associated with long-term intubation and
tracheotomy, laryngeal and tracheal lesions continue to be problematic in patients
requiring prolonged airway support. The incidence of laryngeal complications has been
evaluated in a number of studies, with a wide variety of results [
1
,
4
,
5
]. Significant difficulty is involved in attempts to categorize the spectrum and pathophysiology
of disease in this critically ill population, due to loss of follow up, heterogeneous
patient populations, and the vague symptoms associated with many of these entities.
This article focuses on the long-term consequences of artificial airways, specifically
on injury to the proximal airway.To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.
Content published before 2002 is available via pay-per-view purchase only.
Subscribe:
Subscribe to Clinics in Chest MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Complications and consequences of endotracheal intubation and tracheotomy. A prospective study of 150 critically ill adult patients.Am J Med. 1981; 70: 65-76
- Histopathology of endotracheal intubation. An autopsy study of 99 cases.Arch Pathol. 1969; 88: 511-520
- A report of 342 cases of prolonged endotracheal intubation.Med J Aust. 1968; 2: 529-533
- Prolonged endotracheal intubation.Acta Anaesthesiol Scand Suppl. 1970; 33: 1-131
- Risk factors associated with prolonged intubation and laryngeal injury.Otolaryngol Head Neck Surg. 1994; 111: 453-459
- Early complications of airway management in head-injured patients.Laryngoscope. 1990; 100: 958-961
- Post intubation laryngeal sequelae in an intensive care unit.J Laryngol Otol. 1995; 109: 313-316
- Histologic changes produced by endotracheal intubation.Ann Otol Rhinol Laryngol. 1965; 74: 799-812
- Subglottic tracheal stenosis.Semin Thorac Cardiovasc Surg. 1994; 6: 200-205
- Subglottic stenosis: a clinicopathological study.Clin Otolaryngol. 1985; 10: 315-327
- Arytenoid dislocation: diagnosis and treatment.Laryngoscope. 1994; 104: 1353-1361
- Iatrogenic ruptures of the tracheobronchial tree.Eur J Cardiothorac Surg. 2002; 21: 649-652
- Laryngeal injury following short-term intubation.Ann Otol Rhinol Laryngol. 1983; 92: 327-330
- L'arthrite crico-arytenoidienne: une cause d'obstruction des voies respiratoires superieures dans l'arthrite rhumatoide.Can J Anaesth. 2002; 49 ([in French]): 729-732
- Acute cricoarytenoid arthritis: local periarticular steroid injection.Ann Otol Rhinol Laryngol. 1980; 89: 558-562
- Sudden death from cord compression associated with atlanto-axial instability in rheumatoid arthritis. A case report.Spine. 1990; 15: 338-341
- Diseases of the larynx. Arnold, London2000: 860
- Prevention of complications from prolonged tracheal intubation.Am J Surg. 1978; 135: 452-457
- Pressure on the tracheal mucosa from cuffed tubes.BMJ. 1979; 1: 1173-1174
- Airway complaints and laryngeal pathology after intubation with an anatomically shaped endotracheal tube.Acta Anaesthesiol Scand. 1983; 27: 339-344
- The conformity of an anatomically shaped endotracheal tube to the shape of the airway.Acta Anaesthesiol Scand. 1983; 27: 335-338
- Endoscopic evolution of laryngeal injuries caused by translaryngeal intubation.Eur Arch Otorhinolaryngol. 1997; 254: S97-S100
- A prospective study of laryngotracheal sequelae in long-term intubation.Laryngoscope. 1984; 94: 367-377
- Resolution of laryngeal injury following translaryngeal intubation.Am Rev Respir Dis. 1992; 145: 361-364
- Laryngotracheal injury due to endotracheal intubation: incidence, evolution, and predisposing factors. A prospective long-term study.Crit Care Med. 1983; 11: 362-367
- Size of endotracheal tube and neonatal acquired subglottic stenosis. Study Group for Neonatology and Pediatric Emergencies in the Parisian Area.Arch Otolaryngol Head Neck Surg. 1993; 119: 815-819
- Factors influencing acquired subgottic stenosis in infants.J Pediatr. 1986; 109: 322-327
- Nitrous oxide increases endotracheal cuff pressure and the incidence of tracheal lesions in anesthetized patients.Anesth Analg. 1999; 89: 187-190
- Blood flow in the rabbit tracheal mucosa under normal conditions and under the influence of tracheal intubation.Acta Anaesthesiol Scand. 1977; 21: 81-94
- A low-pressure cuff for tracheostomy tubes to minimize tracheal injury. A comparative clinical trial.J Thorac Cardiovasc Surg. 1971; 62: 898-907
- A study of endotracheal tube injury to the subglottis.Laryngoscope. 1985; 95: 1216-1219
- Acquired subglottic stenosis caused by methicillin resistant Staphylococcus aureus that produce epidermal cell differentiation inhibitor.Arch Dis Child Fetal Neonatal Ed. 2001; 84: F38-F39
- Role of infection in the development of acquired subglottic stenosis in neonates with prolonged intubation.Pediatr Int. 2000; 42: 508-513
- The hazards of tracheostomy.Va Med Mon. 1969; 96: 133-141
- Tracheostomy-related subglottic stenosis: bacteriologic pathogenesis.Laryngoscope. 1979; 89: 857-865
- A management strategy for vocal process granulomas.Laryngoscope. 1999; 109: 301-306
- Association of laryngopharyngeal reflux disease and subglottic stenosis.Ann Otol Rhinol Laryngol. 2001; 110: 606-612
- Laryngopharyngeal reflux: position statement of the committee on speech, voice, and swallowing disorders of the American Academy of Otolaryngology-Head and Neck Surgery.Otolaryngol Head Neck Surg. 2002; 127: 32-35
- The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury.Laryngoscope. 1991; 101: 1-78
- Interview method affects incidence of postoperative sore throat.Anaesthesia. 1987; 42: 1104-1107
- The influence of endotracheal tube cuff design and cuff lubrication on postoperative sore throat.Anesthesiology. 1983; 58: 376-379
- Reduction of postoperative sore throat with new endotracheal tube cuffs.Anesthesiology. 1980; 52: 257-259
- Postoperative sore throat after ambulatory surgery.Br J Anaesth. 2002; 88: 582-584
- Postoperative throat complaints after tracheal intubation.Br J Anaesth. 1994; 73: 786-787
- Intraoperative electromyographic assessment of recurrent laryngeal nerve stress and pharyngeal injury during anterior cervical spine surgery with Caspar instrumentation.J Neurosurg. 1999; 91: 170-174
- Correlation of endotracheal tube size with sore throat and hoarseness following general anesthesia.Anesthesiology. 1987; 67: 419-421
- Postoperative sore throat: influence of tracheal tube lubrication versus cuff design.Can Anaesth Soc J. 1980; 27: 156-158
- Hoarseness after tracheal intubation.Anaesthesia. 1992; 47: 213-216
- Voice changes after thyroidectomy: role of the external laryngeal nerve.Br Med J (Clin Res Ed). 1984; 289: 1412-1415
- Postintubation phonatory insufficiency: an elusive diagnosis.Otolaryngol Head Neck Surg. 2001; 124: 625-633
- Ultrasonographic bedside evaluation of maxillary sinus disease in mechanically ventilated patients.Intensive Care Med. 1997; 23: 393-398
- Comparison of B-mode ultrasound and computed tomography in the diagnosis of maxillary sinusitis in mechanically ventilated patients.Crit Care Med. 2001; 29: 1337-1342
- Early diagnosis and treatment of sinusitis in the critically ill trauma patient.Am Surg. 1991; 57: 775-779
- Suppurative sinusitis in critically ill patients: a case report and review of the literature.J Natl Med Assoc. 1992; 84: 1057-1059
- Nosocomial maxillary sinusitis during mechanical ventilation: a prospective comparison of orotracheal versus the nasotracheal route for intubation.Intensive Care Med. 1990; 16: 390-393
- Risk factors and clinical relevance of nosocomial maxillary sinusitis in the critically ill.Am J Respir Crit Care Med. 1994; 150: 776-783
- Nosocomial pansinusitis in orotracheally intubated critically ill patients.Acta Otorhinolaryngol Belg. 1995; 49: 251-255
- Nosocomial sinusitis with isolation of anaerobic bacteria in ICU patients.Intensive Care Med. 1999; 25: 1066-1071
- A randomized study assessing the systematic search for maxillary sinusitis in nasotracheally mechanically ventilated patients. Influence of nosocomial maxillary sinusitis on the occurrence of ventilator-associated pneumonia.Am J Respir Crit Care Med. 1999; 159: 695-701
- Nosocomial sinusitis.JAMA. 1982; 247: 639-641
- Changing etiology of vocal fold immobility.Laryngoscope. 1998; 108: 1346-1350
- Bilateral vocal cord paralysis following endotracheal intubation.Anaesth Intensive Care. 1995; 23: 350-351
- Bilateral vocal cord paralysis.Anaesth Intensive Care. 1995; 23: 253
- Unilateral vocal-cord paralysis following endotracheal intubation.Anesthesiology. 1976; 45: 448-449
- Unilateral vocal-cord palsy.Anesthesiology. 1977; 47: 399
- Vocal fold paralysis after anterior cervical spine surgery: incidence, mechanism, and prevention of injury.Laryngoscope. 2000; 110: 1467-1473
- On the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery.Spine. 2000; 25: 2906-2912
- Recurrent laryngeal nerve paralysis. A 10-year review of 564 patients.Auris Nasus Larynx. 1983; : S1-S15
- New insights into the pathomechanism of postintubation arytenoid subluxation.Anesthesiology. 1999; 91: 659-666
- Dislocated arytenoid: an intubation-induced injury.Ann R Coll Surg Engl. 1990; 72: 353-356
- Postintubation arytenoid subluxation.Ann Otol Rhinol Laryngol. 1996; 105: 384-390
- Cricoarytenoid subluxation, computed tomography, and electromyography findings.Head Neck Surg. 1987; 9: 341-348
- Arytenoid subluxation: diagnosis and treatment.Ann Otol Rhinol Laryngol. 1991; 100: 1-9
- Utility of helical computed tomography in the study of arytenoid dislocation and arytenoid subluxation.Ann Otol Rhinol Laryngol. 1997; 106: 1020-1023
- Vocal process granuloma.Ear Nose Throat J. 1997; 76: 382-387
- Problems with prolonged endotracheal intubations.Chest. 1978; 74: 479-480
- Intubation granuloma.Otolaryngol Clin North Am. 1982; 15: 567-579
- Contact granulomas of the larynx.Eur Arch Otorhinolaryngol. 1994; 251: 67-71
- [Influence of protracted halothane-nitrous-oxide anesthesia on granuloma development in the rat].Anaesthesist. 1971; 20: 55-56
- Treatment of vocal fold granuloma using botulinum toxin type A.Laryngoscope. 1995; 105: 585-588
- Topical inhalant steroid (budesonide, Pulmicort nasal) therapy in intubation granuloma.J Laryngol Otol. 1999; 113: 427-432
- Arytenoid granuloma.J Laryngol Otol. 1997; 111: 801-803
- Treatment of vocal cord granuloma.Acta Otolaryngol. 1989; 107: 296-299
- Posterior commissure stenosis post long-term intubation.Laryngoscope. 1983; 93: 1314-1318
- Incidence and pathogenesis of tracheal injury following cuffed tube tracheostomy with assisted ventilation: analysis of a two-year prospective study.Ann Surg. 1971; 173: 249-263
- Posterior glottic laryngeal stenosis.Otolaryngol Head Neck Surg. 1980; 88: 765-772
- Endoscopic microsurgical management of scars in the posterior commissure and interarytenoid region resulting in vocal cord pseudoparalysis.Eur Arch Otorhinolaryngol. 1999; 256: 412-414
- Evaluation and management of bilateral vocal cord immobility.Otolaryngol Head Neck Surg. 1999; 121: 760-765
- Postintubation interarytenoid adhesion.Ann Otol Rhinol Laryngol. 2000; 109: 736-740
- Laryngotracheal injury following cricothyroidotomy.Laryngoscope. 1989; 99: 125-130
- Adult long-segment tracheal stenosis attributable to complete tracheal rings masquerading as asthma.Crit Care Med. 2002; 30: 238-240
- Correlation between functional, radiological and anatomical abnormalities in upper airway obstruction (UAO) due to tracheal stenosis.Acta Otorhinolaryngol Belg. 1995; 49: 331-339
- Helical computed tomography for the evaluation of tracheal stenosis.Ann Thorac Surg. 1995; 60 ([discussion: 30–1]): 27-30
- Imaging of laryngeal and tracheal stenosis.Acta Otorhinolaryngol Belg. 1995; 49: 323-329
- 2D and 3D CT imaging correlated to rigid endoscopy in complex laryngo-tracheal stenoses.Eur Radiol. 2001; 11: 50-54
- Virtual bronchoscopy.Clin Chest Med. 1999; 20: 725-730
- Evaluation of airway obstruction using virtual endoscopy.Laryngoscope. 2000; 110: 23-29
- Surgical repair of late glottic stenosis.Ann Otol Rhinol Laryngol. 1968; 77: 435-441
- Endoscopic laser repair of posterior glottic, subglottic and tracheal stenosis by division or micro-trapdoor flap.Laryngoscope. 1984; 94: 445-450
- The endoscopic Teflon keel for posterior and total glottic stenosis.Laryngoscope. 1989; 99: 571-577
- The use of buccal mucosa graft at posterior cricoid splitting for subglottic stenosis repair.Laryngoscope. 2001; 111: 2191-2194
- Minimally invasive surgery for posterior glottic stenosis.Otolaryngol Head Neck Surg. 1999; 121: 153-156
- Botulinum toxin: adjunctive treatment for posterior glottic synechiae.Laryngoscope. 1999; 109: 855-857
- Management of subglottic stenosis in the adult.Ann Otol Rhinol Laryngol. 1991; 100: 90-94
- Posterior glottic stenosis mechanism and surgical management.Laryngoscope. 1997; 107: 675-679
- Posterior glottic stenosis and bilateral vocal fold immobility: diagnosis and treatment.Otolaryngol Clin North Am. 2000; 33: 855-878
- Carbon dioxide laser management of laryngeal stenosis.Ann Otol Rhinol Laryngol. 1985; 94: 565-569
- The management of posterior glottic stenosis following endotracheal intubation.Aust N Z J Surg. 1994; 64: 621-625
- Concentric tracheal and subglottic stenosis. Management using the Nd-YAG laser for mucosal sparing followed by gentle dilatation.Chest. 1993; 104: 673-677
- Multidisciplinary approach to management of postintubation tracheal stenoses.Eur Respir J. 1999; 13: 888-893
- Acquired tracheomalacia: etiology and differential diagnosis.Chest. 1975; 68: 340-345
- The evolution of tracheal injury due to ventilatory assistance through cuffed tubes: a pathologic study.Ann Surg. 1969; 169: 334-348
- Pediatric tracheobronchomalacia and major airway collapse.Ann Otol Rhinol Laryngol. 1992; 101: 300-309
- Treatment of severe bronchomalacia with expanding endobronchial stents.Arch Otolaryngol Head Neck Surg. 1990; 116: 1087-1090
- A tracheostomy complication resulting from acquired tracheomalacia: case report.J Trauma. 2001; 50: 120-123
- A case of tracheomalacia during isoflurane anesthesia.Anesth Analg. 1995; 80: 1051-1053
- Pulmonary function in patients with relapsing polychondritis.Chest. 1982; 81: 711-717
- Acquired tracheomalacia: detection by expiratory CT scan.J Comput Assist Tomogr. 2001; 25: 394-399
- [Diagnosis, incidence, clinicopathology and surgical treatment of acquired tracheobronchomalacia].Nihon Kyobu Shikkan Gakkai Zasshi. 1992; 30: 1028-1035
- Trachea stabilisation with autologous costal cartilage in acquired tracheomalacia: report of two cases.East Afr Med J. 2001; 78: 330-331
- Expanding wire stents in benign tracheobronchial disease: indications and complications.Ann Thorac Surg. 1992; 54: 937-940
- Endobronchial management of benign, malignant, and lung transplantation airway stenoses.Ann Thorac Surg. 1995; 59: 1417-1422
- Self-expandable metallic airway stent insertion employing flexible bronchoscopy: preliminary results.Chest. 1998; 114: 106-109
- Tracheostomy in the intensive care unit. Part 1: indications, technique, management.Chest. 1986; 90: 269-274
- Tracheostomy in the intensive care unit. Part 2: complications.Chest. 1986; 90: 430-436
- Late complications of tracheotomy.Clin Chest Med. 1991; 12: 597-609
- Factors influencing choice between tracheostomy and prolonged translaryngeal intubation in acute respiratory failure: a prospective study.Anesth Analg. 1976; 55: 195-201
- Planning and management of long-standing tracheostomy.Otolaryngol Head Neck Surg. 1987; 97: 385-390
- Healing of lesions caused by cuffed tracheostomy tubes and their late sequelae; a follow-up study.Acta Anaesthesiol Scand. 1980; 24: 169-177
- Incidence of tracheal stenosis and other late complications after percutaneous tracheostomy.Ann Surg. 2000; 232: 233-241
- Long-term follow-up of Griggs percutaneous tracheostomy with spiral CT and questionnaire.Chest. 2000; 117: 1430-1433
- Imaging of tracheobronchial injuries.J Thorac Imaging. 1995; 10: 206-219
- The evaluation of tracheal abnormalities by tomography.Radiol Clin North Am. 1976; 14: 95-104
- Stenosis of the larynx and trachea: diagnostics and treatment.Otolaryngol Pol. 2001; 55: 515-520
- The impact of percutaneous tracheostomy on intensive care unit practice and training.Anaesthesia. 1999; 54: 186-189
- The technique of percutaneous tracheostomy. Using serial dilation to secure an airway with minimal risk.J Crit Illn. 1993; 8: 289-297
- A comparison of percutaneous and operative tracheostomies in intensive care patients.Can J Anaesth. 1995; 42: 775-779
- Percutaneous dilational tracheostomy: report of 356 cases.J Trauma. 1996; 41 ([discussion: 243–4]): 38-43
- Bedside tracheostomy in the intensive care unit.Arch Surg. 1996; 131 ([discussion: 554–5]): 552-554
- Surgical tracheostomy versus percutaneous dilatational tracheostomy. A prospective-randomized study with long-term follow-up.J Cardiovasc Surg (Torino). 2002; 43: 113-121
- Comparative clinical trial of standard operative tracheostomy with percutaneous tracheostomy.Crit Care Med. 1991; 19: 1018-1024
- Percutaneous dilatational tracheostomy: results and long-term outcome of critically ill patients following cardiac surgery.Thorac Cardiovasc Surg. 1998; 46: 352-356
- Late outcome from percutaneous tracheostomy using the Portex kit.Chest. 1999; 115: 1070-1075
- The long-term complications of percutaneous dilatational tracheostomy.Am Surg. 1998; 64 ([discussion: 86–7]): 82-86
- Percutaneous dilatational tracheostomy—early results and long-term outcome of 326 critically ill patients.Intensive Care Med. 1998; 24: 685-690
- Complications of percutaneous tracheostomy.Chest. 2001; 119: 1282-1283
- Pathologic changes of the trachea after percutaneous dilatational tracheotomy.Chest. 1996; 109: 1466-1469
- Tracheal lesion caused by percutaneous dilatational tracheostomy—a clinico-pathological study.Intensive Care Med. 1999; 25: 102-105
- Obstructive suprastomal granulation tissue following percutaneous tracheostomy.Anaesth Intensive Care. 1999; 27: 596-600
- Percutaneous dilational tracheostomy: the Ciaglia method versus the Portex [correction of Rapitrach] method.Anesth Analg. 1998; 87: 556-561
- Laryngotracheoscopic findings in long-term follow-up after Griggs tracheostomy.Chest. 2002; 122: 206-212
- Clinical experience with Ciaglia's percutaneous tracheostomy.Eur Arch Otorhinolaryngol. 1999; 256: 426-428
- Percutaneous dilation of tracheal stenosis.Chest. 1999; 115: 1751-1752
- Trachea-innominate artery fistula: retrospective comparison of treatment methods.South Med J. 1988; 81: 701-706
- Trachea-innominate artery fistula: successful management of 3 consecutive patients.Ann Thorac Surg. 1977; 24: 439-447
- Management of acquired tracheoesophageal fistula.Chest Surg Clin N Am. 1996; 6: 819-836
- Tracheoesophageal fistula after blunt chest trauma: successful diagnosis by computed tomography.Thorac Cardiovasc Surg. 2000; 48: 102-103
- Tracheoesophageal fistula: diagnosis with CT.Pediatr Radiol. 1985; 15: 134-135
- Esophageal atresia and tracheal stenosis: use of three-dimensional CT and virtual bronchoscopy in neonates, infants, and children.AJR Am J Roentgenol. 2000; 174: 1009-1012
- Bifurcate tracheal stent with foam cuff for tracheo-esophageal fistula: utilization of reconstruction modes of spiral computed tomography.Thorac Cardiovasc Surg. 1994; 42: 367-369
- Acquired tracheoesophageal fistula in critically ill patients.Ann Otol Rhinol Laryngol. 2000; 109: 731-735
- Tracheoesophageal fistula caused by cuffed tracheal tube. Successful treatment by tracheal resection and primary repair with four-year follow-up.Arch Surg. 1978; 113: 338-340
- Evaluation and outcome of different surgical techniques for postintubation tracheoesophageal fistulas.J Thorac Cardiovasc Surg. 2000; 119: 268-276
Article info
Identification
Copyright
© 2003 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
