Videolaryngoscopic evaluation of laryngeal intubation injury: incidence and predictive factors.

Bedside videolaryngoscopy of 73 cardiovascular surgical patients was performed before and after intubation to identify risk factors, incidence, and site of injury to the larynx. Nineteen of 44 patients with abnormal preintubation examination findings had granulation tissue present on a vocal process, compared With 3 of 20 patients who had normal findings on preintubation examination (p < 0.05). Recent smoking history was elicited from 2 of 20 patients who had normal findings on preintubation examination and from 20 of the 44 patients who had abnormal findings on preintubation examination (p < 0.01). Laryngeal nerve paresis was identified in 21 of 64 patients after extubation and was present in 7 patients before intubation. Videolaryngoscopy provides a high-quality permanent record of the laryngeal examination and is easily obtained in the critical care setting. Preintubation videolaryngeal evaluation may identify those at risk for more significant intubation injury.