{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T23:52:53Z","timestamp":1793231573365,"version":"4.5.0"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,5,18]],"date-time":"2016-05-18T00:00:00Z","timestamp":1463529600000},"content-version":"vor","delay-in-days":7900,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[1994,10]]},"abstract":"<jats:p>A prospective study evaluated potential risk factors associated with laryngeal Injury after prolonged endotracheal tube intubation for longer than 3\u00a0days. Ninety\u2010seven patients were evaluated after oral endotrachael tube intubation (mean, 9\u00a0days). This study updates a previously reported evaluation of 44 patients. The additional sample size has provided findings of unreported patient risk factors of laryngeal injury and confirmation of previous associations. The majority of the 97 patients had some type of laryngeal injury, ranging from mild mucosal erythema to ulceration, granuloma formation, or true vocal cord immobility. Patient examinations were continued until the larynx returned to normal or stabilized or the patient was lost to follow\u2010up. Postextubation examinations in the survival group revealed the following. (1) Laryngeal erythema occurred in 94%, and ulceration occurred in 76% of the patients with resolution within 6 weeks. (2) Laryngeal granulomas occurred in 44% of the patients; the majority of the granulomas (57%) developed an average of 4 weeks <jats:italic>after<\/jats:italic> extubation. Associated risk factors included duration of endotracheal tube Intubation (<jats:italic>p<\/jats:italic> &lt; 0.05) and presence of nasogastric tube (<jats:italic>p<\/jats:italic> &lt; 0.05). (3) Vocal cord immobility was observed in 16 patients (20%). Eight patients had true vocal cord immobility noted initially after extubation, and the remaining eight had true vocal cord immobility an average of 4 weeks <jats:italic>after<\/jats:italic> extubation. Initial and delayed true vocal cord immobility were associated with duration of intubation and size of endotracheal tube (<jats:italic>p<\/jats:italic> &lt; 0.01). Delayed true vocal cord immobility developed only in patients with a size 8 endotracheal tube. Implications generated from this study would suggest the use of antacids and histamine, receptor antagonist medications for patients requiring a nasogastric tube and the use of smaller diameter endotracheal tubes.<\/jats:p>","DOI":"10.1177\/019459989411100411","type":"journal-article","created":{"date-parts":[[2017,7,13]],"date-time":"2017-07-13T00:52:48Z","timestamp":1499907168000},"page":"453-459","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":159,"title":["Risk Factors Associated with Prolonged Intubation and Laryngeal Injury"],"prefix":"10.1002","volume":"111","author":[{"given":"Perry M.","family":"Santos","sequence":"first","affiliation":[{"name":"Division of Otolaryngology Southern Illinois University Springfield Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Afrassiabi","sequence":"additional","affiliation":[{"name":"Department of Anesthesia University of Southern California Medical Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Ernest A.","family":"Weymuller","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Washington Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,18]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198403000-00014"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348947908800405"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(81)90413-7"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1969.tb00750.x"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198305000-00009"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198808001-00001"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348948909801204"},{"key":"e_1_2_1_9_1","first-page":"511","article-title":"Histopathology of endotracheal intubation: An autopsy study of 99 cases","volume":"88","author":"Donnelly WH","year":"1969","journal-title":"Arch Pathol"},{"key":"e_1_2_1_10_1","first-page":"88","article-title":"Fusion of the vocal cords following intubation and tracheostomy","volume":"77","author":"Kirchner JA","year":"1973","journal-title":"Trans Am Acad Ophthalmol Otolaryngol"},{"issue":"53","key":"e_1_2_1_11_1","first-page":"54","article-title":"The otolaryngologic manifestations of gastroesophageal reflux disease","volume":"101","author":"Koufman JA","year":"1991","journal-title":"Laryngoscope"},{"key":"e_1_2_1_12_1","first-page":"1057","article-title":"Complications of endotracheal intubation in the elderly","volume":"23","author":"Santos PM","year":"1990","journal-title":"Otolaryngol Clin"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/019459989411100411","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/019459989411100411","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:58:18Z","timestamp":1760968698000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/019459989411100411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,10]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1994,10]]}},"alternative-id":["10.1177\/019459989411100411"],"URL":"https:\/\/doi.org\/10.1177\/019459989411100411","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[1994,10]]},"assertion":[{"value":"1993-09-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1994-03-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-05-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}