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Changes in the cricoarytenoid joint induced by intubation in neonates

Shyan Vijayasekaran1, Richard Sances, Robin Cotton

  • 1Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.

Archives of Otolaryngology--Head & Neck Surgery
|December 21, 2006
PubMed

Insights

Prolonged intubation in infants can cause vocal cord fixation due to histopathologic changes in the cricoarytenoid joint (CAJ). This study found hemorrhage, infection, inflammation, and fibrosis in the CAJ, correlating with intubation duration.

Area of Science:

  • Pediatric Otolaryngology
  • Laryngeal Pathology
  • Intubation Complications

Background:

  • Vocal cord fixation is a significant complication in children following prolonged intubation.
  • The precise mechanisms underlying this immobility, particularly at the cricoarytenoid joint (CAJ), require further elucidation.

Purpose of the Study:

  • To histopathologically characterize the cricoarytenoid joint (CAJ) in infants.
  • To understand the mechanisms of vocal cord fixation after prolonged endotracheal intubation in children.

Main Methods:

  • Histologic analysis of laryngeal specimens from infants with varying intubation durations (1-30 days).
  • Examination focused on the histopathologic characteristics of the cricoarytenoid joint (CAJ).

Main Results:

  • Infant laryngeal specimens from prolonged intubation showed evidence of hemorrhage, infection, inflammation, and fibrosis within the CAJ.
  • A statistically significant correlation was observed between the duration of intubation and the presence of these CAJ histologic abnormalities.

Conclusions:

  • This study provides the first demonstration of histologic changes in the CAJ in children after prolonged intubation.
  • These observed histological alterations in the CAJ may explain the mechanism of vocal cord immobility in pediatric patients post-intubation.
Abstract

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