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Updated: Jun 23, 2026
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The Rigid Tube as an Alternative in Controlling the Problematic Airway
Published on: June 6, 2020
Risk Factors for Intubation-Related Laryngeal Granulomas: A Prospective Study in Surgical Patients.
Summary
Intubation-related laryngeal granulomas (ILGs) occurred in 25% of patients, with prolonged intubation and double-lumen tube (DLT) use identified as key risk factors. Most ILGs resolved spontaneously within a month.
Area of Science:
- Anesthesiology
- Otolaryngology
- Critical Care Medicine
Background:
- Intubation-related laryngeal granulomas (ILGs) are a potential complication following surgery under general anesthesia.
- Identifying risk factors is crucial for prevention and management strategies.
Purpose of the Study:
- To determine the incidence of ILGs after surgery.
- To identify risk factors, specifically focusing on endotracheal tube type and duration of intubation.
Main Methods:
- A prospective cohort study of 40 adult patients undergoing long-duration elective surgery (≥5 hours) from November 2012 to September 2013.
- Fiberoptic laryngoscopy was performed post-extubation at multiple time points (day 1, 1 week, 1 month, 3 months).
- Candidate variables included tube type (single-lumen vs. double-lumen [DLT]), intubation duration, Cormack-Lehane grade, TEE, GERD, BMI, sex, and age, analyzed via univariate and multivariable logistic regression.
Main Results:
- ILGs were detected in 25% of patients at 1 week post-extubation, predominantly after cardiovascular surgery.
- Prolonged intubation (≥13 hours) and the use of DLTs were significantly associated with ILG development (p=0.013 and p=0.020, respectively).
- Most ILGs (80%) resolved spontaneously by 1 month; 20% required inhaled steroid therapy for complete resolution by 3 months.
Conclusions:
- ILGs are relatively common (25% incidence at 1 week) and typically resolve within a month.
- Prolonged intubation duration and DLT use are independent risk factors for ILG.
- Consideration should be given to using the smallest appropriate DLT and performing early laryngoscopy in high-risk patients.
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