[Two cases of postintubation granuloma of the larynx]

We herein report two cases with postintubation granuloma of the larynx. Under general anesthesia, a 72-year-old man underwent off-pump coronary artery bypass grafting and a 67-year-old woman underwent AVR, MVR, and TVP. Both patients became unable to breathe for more than one month after extubation, and a granuloma of the larynx was found which thereafter disappeared with conservative therapy in both cases. We found that the two cases had following four points in common. Namely, they had both undergone cardiac operations for a low cardiac output, they were both intubated for over 96 hours, a Hi-Lo Evac tube was used for both cases, and finally, laryngeal glanuloma were observed to develop on the membranous wall of the trachea. We concluded that suctioning above the endotracheal tube cuff was the cause of postintubation granuloma of the larynx. We should keep in mind the fact that postintubation granuloma of the larynx might develop several months after extubation, and careful airway manipulation both during and after the operation is thus needed to avoid this potential complication.