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Published on: January 17, 2011

Crico-arytenoid joint obliteration following longterm intubation in the premature infant

M D Morrison, B R Maber

    The Journal of Otolaryngology
    |August 1, 1977
    PubMed

    Insights

    Endotracheal intubation in premature infants with hyaline membrane disease can cause severe laryngeal damage. Cole endotracheal tubes led to crico-arytenoid joint destruction, impacting infant survival.

    Area of Science:

    • Pediatric Medicine
    • Otolaryngology
    • Neonatology

    Background:

    • Premature infants with hyaline membrane disease often require endotracheal intubation for respiratory support.
    • Cole endotracheal tubes have been used in neonatal intensive care, but their long-term effects on laryngeal anatomy are not fully understood.

    Purpose of the Study:

    • To investigate the laryngeal pathology in premature infants who died following intubation with Cole endotracheal tubes.
    • To determine the impact of endotracheal intubation and tracheotomy on the crico-arytenoid joints.

    Main Methods:

    • Post-mortem examination of the larynges of two premature male twins.
    • Serial sectioning of the crico-arytenoid joints.
    • Comparison of affected larynges with normal anatomical specimens.

    Main Results:

    • Both infants exhibited destruction of the crico-arytenoid joints.
    • Inflammatory granulation tissue led to the obliteration of these joints.
    • One infant died at 25 weeks of cor pulmonale, while the other died at 32 weeks after tracheotomy.

    Conclusions:

    • Endotracheal intubation with Cole tubes can cause irreversible damage to the crico-arytenoid joints in premature infants.
    • This laryngeal pathology may contribute to respiratory complications and mortality.
    • Further research is needed to explore alternative intubation methods and management strategies.

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