The Hazards of Endotracheal Intubation

Short-Term Effects of Endotracheal Intubation on Voice

“…The fear of long-term complications from the use of the endotracheal tube has stimulated various authors to investigate the laryngotracheal morphological and histological changes witnessed after prolonged intubation. [1][2][3] Less attention has been given to the short-term vocal changes that are consistently associated with general anesthesia and convincingly perceived by experienced listeners as roughness, decreased affect, and intensity of the vocal signal. Symptoms often resolve in 12-72 hours unless substantial damage has occurred, such as arytenoids dislocation, granulomas and ulcers have been formed, or recurrent laryngeal nerve paresis has occurred.…”

Anesthesia Care for the Professional Singer

“…Although the consequences of long-term endotracheal tube intubation have been well documented, [6][7][8] there has been less attention given to the effects of short-term intubation. After short-term intubation, as typically associated with general anesthesia, the experienced listener may detect elements of roughness, strain, breathiness, and weakness to the voice.…”

Prolonged Intubation Versus Tracheostomy in the Adult

“…Laryngeal damage (erythema, inflammation, or mucosal ulceration) is invariably found and is most severe over the vocal processes of the arytenoid cartilages, the posterior commissure, and the posterior-lateral subglottis (Fig 5) [35,[56][57][58][59][60][61][62]. These studies further pointed out that two variablesduration of TLI and size of the tracheal tube-have an important influence on the degree of laryngeal damage.…”

“…These studies further pointed out that two variablesduration of TLI and size of the tracheal tube-have an important influence on the degree of laryngeal damage. Mucosal ulcerations were apparent after only several hours of TLI [55,58,60,61] and became progressively deeper and wider as the duration of TLI was lengthened [56][57][58][59][60][61][62]. The larger the tracheal tube in relation to laryngeal size, the more severe the subsequent laryngeal damage [55][56][57].…”

“…This was usually caused by some combination of glottic ulceration plus edema, vocal cord dysfunction, and subglottic edema. The incidence of this ranged from less than 1 % in some studies [62,[77][78][79][80][81]] to 5.5% in others [35,47,82,83]. Fortunately, stridor on extubation was not always severe in these cases, and many patients could be treated conservatively without tracheostomy until the airway obstruction subsided [35,82].…”