1995 Volume 46 Issue 4 Pages 292-296
Postintubation granulomas of the larynx are one of the possible complications following tracheal intubation. Though there have been many reports on their etiology, clinical cause and management, there have been few reports dealings with children.
Between April 1989 and March 1994 we have seen postintubation granulomas in six children aged 11 months to 15 years.
1) Their chief complaints were hoarseness, dysphonia, dyspnea and decannulation.
2) Four of the children had a systemic complication. Two of these four children had severe cerebral palsy.
3) In four children intubation was necessary for the respiratory control post-operation. In the others, intubation was carried out for respiratory control only because of their disease.
4) The intubation lasted for from 2 days to 4 weeks.
5) Conservation treatment of laryngeal nebulization with steroid and epinephrine was effective. In four children the size of the granulomas remarkably decreased after the laryngeal nebulization, but in the other two children with cerebral palsy it was not so effective. For these children, tracheostomies were performed because of the decannulation.
6) In children severely mentally or physically handicapped, it is considered granulomas of the larynx can easily occur.
We think that an abnormally hypertonic condition of the muscles and a frequent over extensive position of the head and neck will be important to reveal the etiology of granulomas of the larynx.
