Wydawnictwo Medyczne Mediton
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Under the scientific patronage of

the Polish Society of Audiology and Phoniatrics

 

Original articles

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Endoscopic evaluation of early post-intubation lesions of larynx in children
Lidia Zawadzka-Głos, Krzysztof Ślączka 1/
  • 1/ Klinika Otolaryngologii Dziecięcej Warszawskiego Uniwersytetu Medycznego

Introduction. Prolonged intubation in children may result in post-intubation changes at the level of the larynx. These changes are referred to as early (acute) or late (chronic). Early lesions are observed during, or shortly after the extubation. Late changes occur after a week or longer following the extubation.
Aim. The aim of this work is the analysis of early post-intubation changes in the larynx in children.
Material and methods. Endoscopic examination of the larynx was performed in a group of 65 children aged 3 weeks to 4 years, intubated due to respiratory failure. The assessment was performed using 0° and 30° endoscopic optics under general anesthesia in 10 to 21 days of intubation.
Results. In our group, laryngeal endoscopy revealed subglottic edema in 30 (46%) patients, subglottic ulceration in 29 (44.6%)
patients and granulation of vocal folds in 5 cases. There were 3 cases with nonspecific lesion. Acute injuries related to the intubation procedure were recognized in some cases as well. Five children had more than one post-intubation lesion.
Conclusion. Endoscopic visualization allows assessment of specific progression of post-intubation lesions in cases of prolonged intubation. Endoscopy is recommended in first or second week of intubation in children. In newborns it is advisable to perform larynx endoscopy in cases of extubation failure. Therapeutic management of child is related to the severity of post-intubation lesion.

Otorynolaryngologia vol 14. no 1. Marchpages: from 20to 24
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