The Management of Postintubation Phonatory Insufficiency

Summary Introduction Prolonged intubation may lead to medial arytenoid cartilage erosion and cricoarytenoid joint scarring with subsequent glottic insufficiency. This has been referred to as postintubation phonatory insufficiency (PIPI). Reports on treatment outcomes for this condition are lacking....

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Bibliographic Details
Published in:Journal of voice 2012-07, Vol.26 (4), p.530-533
Main Authors: Arviso, Lindsey C, Klein, Adam M, Johns, Michael M
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Female
Humans
Intubation
Intubation, Intratracheal - adverse effects
Keyhole aperture
Laryngeal trauma
Male
Middle Aged
Otolaryngology
Phonation
Phonatory insufficiency
Posterior glottic insufficiency
Retrospective Studies
Voice Disorders - etiology
Voice Disorders - therapy
Young Adult
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Summary:Summary Introduction Prolonged intubation may lead to medial arytenoid cartilage erosion and cricoarytenoid joint scarring with subsequent glottic insufficiency. This has been referred to as postintubation phonatory insufficiency (PIPI). Reports on treatment outcomes for this condition are lacking. Methods A single institution retrospective chart review from January 2007 to present was preformed for PIPI diagnosis. Data were collected for intubation, symptoms, diagnosis, interventions, and outcomes. Results Five patients with PIPI underwent treatment to improve voice. Patient 1 underwent thyroplasty with adduction arytenopexy. Patient 2 had a revision thyroplasty and subsequently two injections of the posterior defect and true vocal fold. Patient 3 underwent injection of the medial arytenoid defect. Patient 4 had injection augmentation of the anatomic deficiency and the ipsilateral true vocal fold. Patient 5 underwent thyroplasty with adduction arytenopexy. Limited to no phonatory improvement was achieved in any case. Conclusions The management of patients with PIPI is difficult. Currently, no reliable means are available to restore cartilaginous defects in the respiratory glottis. Patients with this condition should be counseled as to the difficult nature of treatment.
ISSN:0892-1997
1873-4588
DOI:10.1016/j.jvoice.2010.10.022