Laryngeal complications after tracheal intubation and tracheostomy

By reading this article, you should be able to:

• Describe the aetiology, prevalence and risk factors for dysphagia and dysphonia after prolonged translaryngeal intubation and tracheostomy.
• Outline the physiological and psychological impacts of laryngeal dysfunction in the critically ill.
• Discuss relevant investigations, therapeutic strategies and specialist interventions to promote recovery of laryngeal function.
• Summarise the effective multidisciplinary management of common laryngeal complications.

Key points:

• Pharyngolaryngeal injury or dysfunction may have significant consequences for patients recovering from critical illness, including failed extubation and decannulation.
•Early detection of post-extubation dysphagia and dysphonia is important for prevention of avoidable complications.
•Inability to vocalise during critical illness has a significant psychological impact, leading to anxiety, depression and reduced engagement with rehabilitation.
•A variety of interventions can promote early vocalisation and positively impact recovery.
•Management requires a multidisciplinary approach with a fully integrated speech and language therapist.