Effects of Intubation
1) tube obstruction
2) local tissue damage due to infection or pressure
necrosis in the nose, oral cavity, larynx, or subglottic
3) Endobronchial (causes left lung to collapse) or esophageal
Possible antecedent to voice disorders- Cotton (1991) found
that better voices resulted when the duration of the stenting
was less than 12 weeks.
Vocal fold scarring or fibrosis after prolonged endotracheal
or nasogastric intubation.
Damage to the vocal mechanism during intubation or
extubation or from protracted intubation.
Stenosis and other laryngotracheal complications frequently
are secondary to prolonged intubation.
Edema caused by the irritation from nasogastric,
nasotracheal and orotracheal tubes.
Occult Sepsis has also been linked to intubation.
Sinustis and middle ear effusion has also been noted.
Injuries may include:
1) dislocation of arytenoids or mandible
2) interarytenoid fixation
3) vocal fold paralysis
4) synechia of vocal folds or laryngeal web
5) perforation of the piriform sinus or esophagus
6) laryngeal and tracheal stenosis
7) ulcers and granulomas on the vocal processes of
8) damage to oral mechanism (e.g.mouth, teeth, palate, and
Treatments include steroids, antibiotics, and surgery. It is recommended to remove fresh granulation tissue before development of a firm subglottic stenosis after intubation injury.
Cuffed tubes may also contribute to infection, tracheal
stenosis, esophageal erosion, and innominate artery
Interference with swallowing.
Vocal hypofunction is an effect of long term intubation.
Laryngeal webbing may be a result.
Intubation may increase risk of death in patients who have
suppressed immune systems.
Perforation of the trachea or esophagus
Fracture or dislocation of cervical spine
Trauma to eyes
Aspiration of secretions, blood, gastric contents, or foreign
Increased intracranial or introcular pressure
Excuriation of nose or mouth.
Dysphonia (hoarseness), aphonia
Paralysis of vocal folds or hypoglossal, lingual nerves.
Vocal fold granulomata or synechiae