Abstract
Background: Prolonged endotracheal intubation (more than forty eight hours) is needed in critically ill patients after
respiratory failure. Prolonged intubation are usually associated with different laryngeal injures as vocal fold immobility,
ulceration, granulomas and edema. Objectives: To determine the effects of prolonged endotracheal intubation on the
larynx & to assess swallowing ability and presence of aspiration in selected patients. Patients and Methods: This study
was conducted on 54 patients with endotracheal intubation admitted to adult Intensive Care Unit (ICU). When the
patients were eligible for endotracheal extubation. The patients evaluated immediately after extubation or within 24
hours. The patients evaluated by flexible fibroptic-naso-laryngoscope with endoscopic video-recording for the presence
of vocal fold lesions. Also, some patients assessed for swallowing ability and presence of aspiration. Results: Laryngeal
abnormalities were seen in 85% of patients on the day of extubation. Majority of patients (42.6%) had posterior glottal
contusions and laceration, followed by vocal fold immobility (25.9%) and subglottal edema (22.2%). Also subglottic
web and stenosis were found in (14.8%). 30 patients were assessed for swallowing difficulty. Laryngeal spiration was
detected in 66% of those patients. Conclusion: Prolonged laryngeal intubation was associated with different laryngeal
injuries. Size of tubes and duration of intubation are correlated with the severity & number of laryngeal lesions. High risk
of aspiration was observed after prolonged laryngeal intubation.