Laryngeal Complications of Prolonged Intubation Gene L. Colice, M.D., Therese A. Stukel, Ph.D., Bradley Dain, M.S.  CHEST  Volume 96, Issue 4, Pages 877-884 (October 1989) DOI: 10.1378/chest.96.4.877 Copyright © 1989 The American College of Chest Physicians Terms and Conditions

Figure 1 Left: A schematic view looking into the larynx with an endotracheal tube positioned between the vocal cords is shown. Right: At laryngoscopy; following extubation or tracheostomy, ulcers along the posterior aspects of both vocal cords were commonly seen as shown in this schematic. The site of these ulcers corresponds to the area where the translaryngeal endotracheal tube pressed against the vocal cords. CHEST 1989 96, 877-884DOI: (10.1378/chest.96.4.877) Copyright © 1989 The American College of Chest Physicians Terms and Conditions

Figure 2 Posterior view of a larynx removed at autopsy in a patient having had TLI for seven days shows typical ulcers (1) along the posterior aspects of both vocal cords. Swelling of the true and false vocal cords (2) is also apparent. CHEST 1989 96, 877-884DOI: (10.1378/chest.96.4.877) Copyright © 1989 The American College of Chest Physicians Terms and Conditions

Figure 3 Time period of resolution of laryngeal damage, determined by serial laryngoscopies, is shown. Asterisks (*) indicate time periods when moderate and severe adverse clinical events were noted. Two patients died within two weeks and one patient within four weeks of entry into the study of aspiration-related problems. Two patients required tracheostomy (trached) within two weeks of study entry. Four patients had chronic hoarseness (with laryngeal polyps) at four months after entry into the study. One patient (not indicated) had transient stridor immediately postextubation. CHEST 1989 96, 877-884DOI: (10.1378/chest.96.4.877) Copyright © 1989 The American College of Chest Physicians Terms and Conditions