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Intubation granuloma is a benign growth of granulation tissue in the larynx or trachea, which arises from tissue trauma due to endotracheal intubation. [1] This medical condition is described as a common late complication of tracheal intubation, specifically caused by irritation to the mucosal tissue of the airway during insertion or removal of the patient's intubation tube.
Intubation is normally facilitated by using a conventional laryngoscope, flexible fiberoptic bronchoscope, or video laryngoscope to identify the vocal cords and pass the tube between them into the trachea instead of into the esophagus. Other devices and techniques may be used alternatively.
Glottal insufficiency (when the vocal folds cannot close completely, often due to vocal fold paralysis) can also be an underlying cause of contact granulomas. [ 5 ] Contact trauma can occur when a person frequently speaks at a pitch that is lower than their modal voice , especially in vocally-demanding professions like acting, teaching and ...
Optical coherence tomography (OCT) can help observe the progression of the injury. Esophageal pH monitoring can help detect any acid reflux, which can worsen the condition. A laryngoscopy or an endoscope can be inserted and used to see the vocal cords, airway, and esophagus/trachea. Spirometry is a useful way to measure respiratory function.
Indirect laryngoscopy is performed whenever the provider visualizes the patient's vocal cords by a means other than obtaining a direct line of sight (e.g. a mirror). For the purpose of intubation, this is facilitated by fiberoptic bronchoscopes, video laryngoscopes, fiberoptic stylets and mirror or prism optically enhanced laryngoscopes.
Vocal cord paresis, also known as recurrent laryngeal nerve paralysis or vocal fold paralysis, is an injury to one or both recurrent laryngeal nerves (RLNs), which control all intrinsic muscles of the larynx except for the cricothyroid muscle. The RLN is important for speaking, breathing and swallowing.
"We’re shooting your vocal cords, we’re shooting your throat; where you eat, where you swallow, where you talk, breathe, everything goes through here," said Olmos pointing to his throat. "So ...
In patients with known difficult airways, fiberoptic intubation can be considered. This technique involves the use of a flexible fiberoptic bronchoscope for visualization of the vocal cords. The bronchoscope can be passed directly into the trachea and the endotracheal tube can be threaded over the bronchoscope into position.