LXIX Laryngeal Sequelae of Endotracheal Anesthesia

The endotracheal administration of anesthesia has been improved considerably in the past decade. By reducing mortality and morbidity, this modality has made possible many advances in all forms of surgery, especially of the chest, head, and neck. There are, however, some disadvantages: 1. The endotracheal tube is a foreign body and thus can cause irritation. 2. Lubricants and solutions used for cleansing and sterilizing the tube may be irritating and can produce a membrane which obstructs the airway. 3. The lumen of the airway is reduced, an especially hazardous problem in children. 4. The patient must be under deeper anesthesia for intubation than is sometimes necessary for the surgical procedure. 5. There may be trauma to teeth, pharynx, nose, or trachea during intubation. 6. Coughing or straining may cause increased venous pressure, with undesired effects. 7. Bacteria from the nose may be carried to the lower respiratory tract. 8. Pulmonary sequelae may occur. 9. Laryngeal sequelae may occur. It is with laryngeal sequelae that we are concerned in this (1951) presentation, which includes the reports of 8 cases of laryngeal obstruction, with 2 deaths, and 7 cases of laryngeal granulomas.