A Clinical Analysis of Intubation Granuloma

An, Kwang Hyeon; Kim, Sang Yoon; Kim, Jae Ho; Chu, Kwang Chol

Abstract

BACKGROUND: Intubation granuloma of the larynx occurs from direct mechanical irritation of mucosa from a traumatic or prolonged endotracheal intubation. Surgical excision can be accomplished with microlaryngeal instruments or with CO2 laser under general anesthesia.
OBJECTIVE
To investigate clinical characteristics of intubation granuloma and to suggest a jet ventilation technique appropriate in general anesthesia. MATERIAL AND METHOD: The clinical presentation, management of 14 consecutive cases of intubation granuloma were reviewed retrospectively from August, 1989 to December, 1995.
RESULTS
1) Age distribution was mostly in the 20-49 years old group(86%). The ratio of male to female was 2:12, with female predominance. 2) The site of lesions were bilateral in 3 cases and unilateral in 11 cases(left in 2 cases, right in 9 cases). The locations were vocal process of arytenoid cartilage in 12 cases(86%), and posterior 1/3 of true vocal cord other than vocal process in 2 cases(14%). 3) Thirteen cases were developed after general anesthesia using endotracheal intubation and 1 case after endotracheal intubation in drug intoxication. Among the 13 cases of general anesthesia, there were 8 cases of Cesarian section delivery. 4) We used the suspension laryngoscope in all cases, high-frequency jet ventilation technique was used for anesthesia in 8 cases and neuroleptic anesthesia in 6 cases. The CO2 laser was used in 5 cases among the jet ventilation technique. There was no complication associated with jet ventilation.
CONCLUSION
Jet-ventilation is a useful anesthetic technique in removal of intubation granuloma.