This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Critical Care/ Intensive Care Medicine  • Adult Critical Care  • Pediatrics  • Neonatology and Infant Care  • Alert me on articles by topic

Shyan Vijayasekaran, MBBS, FRACS; Richard Sances, MD; Robin Cotton, MD; Ravindhra G. Elluru, MD, PhD

Arch Otolaryngol Head Neck Surg. 2006;132:1342-1345.

Objective  To characterize the histopathologic characteristics of the cricoarytenoid joint (CAJ) as a means to understand the mechanisms of vocal cord fixation in children after prolonged intubation.

Design  Histologic analysis of laryngeal specimens obtained from infants who had died secondary to various causes and who had been intubated from 1 to 30 days.

Main Outcome Measure  Histopathologic characteristics of CAJ.

Results  Laryngeal specimens from infants who had been intubated for prolonged periods of time demonstrated evidence of hemorrhage, infection, inflammation, and fibrosis within the CAJ. Furthermore, a statistical correlation was found between the length of intubation and the presence of these histologic abnormalities.

Conclusions  To our knowledge, this is the first study to demonstrate histologic changes in the CAJ in laryngeal specimens of children who have been intubated for prolonged periods of time. Such histological changes in the CAJ could explain the mechanism of vocal cord immobility in children after intubation.

Author Affiliations: Division of Pediatric Otolaryngology–Head and Neck Surgery (Drs Vijayasekaran, Cotton, and Elluru) and Department of Pathology (Dr Sances), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati (Drs Cotton and Elluru).