Changes in the cricoarytenoid joint induced by intubation in neonates

Arch Otolaryngol Head Neck Surg. 2006 Dec;132(12):1342-5. doi: 10.1001/archotol.132.12.1342.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arytenoid Cartilage / injuries*
  • Arytenoid Cartilage / pathology
  • Cricoid Cartilage / injuries*
  • Cricoid Cartilage / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Intubation, Intratracheal / adverse effects*
  • Laryngeal Diseases / etiology
  • Laryngeal Diseases / pathology*
  • Male
  • Severity of Illness Index
  • Time Factors