Effects of Intubation 

                              

  Major Complications:

        1) tube obstruction

        2) local tissue damage due to infection or pressure        

               necrosis in the nose, oral cavity, larynx, or subglottic 

           trachea.

        3) Endobronchial (causes left lung to collapse) or esophageal 

           intubation

   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            

                arytenoids.

        8) damage to oral mechanism (e.g.mouth, teeth, palate, and 

            tongue) 

        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 

     fistulization. 

  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.

   Laryngospasm

  Perforation of the trachea or esophagus

  Retropharyngeal dissection

  Fracture or dislocation of cervical spine

  Trauma to eyes

  Hemorrhage

  Aspiration of secretions, blood, gastric contents, or foreign 

   bodies.

 Hypoexmia, hypercarbia

 Bradycardia, tachycardia

 Hyperextension

 Increased intracranial or introcular pressure

 Excuriation of nose or mouth.

 Dysphonia (hoarseness), aphonia

 Paralysis of vocal folds or hypoglossal, lingual nerves.

 Sore throat

 Laryngeal incompetence

 Tracheal collapse

 Vocal fold granulomata or synechiae

 

                        

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