Laryngeal Injury From Prolonged Intubation: A Prospective Analysis of Contributing Factors

Objectives/Hypothesis: The factors leading to laryngeal injury due to intubation are not fully understood. This study sought to determine if duration of intubation, size of endotracheal tube, and/or type of endotracheal tube impact the degree of vocal fold immobility and other laryngeal injury upon extubation. Study Design: Prospective study. Methods: Sixty-one adult patients intubated for more than 48 hours were examined by recorded flexible nasolaryngoscopy shortly after extubation. Results: Forty-one percent of patients had some degree of vocal fold immobility. However, neither the duration of intubation (range, 2-28 days; mean, 9.1 days), the size of endotracheal tube (range, 6 to 8), nor the type of endotracheal tube significantly affected the degree of laryngeal injury including vocal fold immobility. Additionally, none of the collected demographic information (age, gender, height, weight) significantly affected the degree of laryngeal injury. Conclusions: In this cohort, duration of intubation, type of endotracheal tube, and size of endotracheal tube do not significantly correlate to the incidence of vocal fold mobility and degree of laryngeal injury noted after prolonged intubation.