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Abstract：
OBJECTIVE: To describe the occurrence of post-extubation laryngitis, analyze its one-year evolution, and correlate laryngeal lesions with clinical outcomes.
METHODS: Retrospective study including children up to 13 years old at a tertiary hospital between March 2020 and March 2022 with diagnosis of post-extubation laryngitis confirmed by endoscopic examination. Exclusion criteria were prior history of intubation or anatomical airway abnormalities. Medical records were reviewed to characterize patients, underlying diagnosis, laryngeal lesions, treatment, and outcomes at 12-month follow-up.
RESULTS: The study included 38 endoscopically confirmed post-extubation laryngitis cases, corresponding to 86.4% of suspected cases. The mean age was 13.24 months, and 60.5% were male. Acute respiratory failure was the leading cause of intubation. Initial treatment was clinical, and initial diagnosis was defined by nasopharynoglaryngoscopy and/or Microlaryngoscopy and Bronchoscopy (MLB) findings. Initial diagnostic MLB was performed in 65.7% of the patients. Approximately half (53%) of the patients exhibited moderate or severe laryngeal lesions. When compared to mild cases, these patients experienced a higher rate of extubation failures (mean of 1.95 vs. 0.72, p = 0.0013), underwent more endoscopic procedures, and faced worse outcomes, such as the increased need for tracheostomy (p = 0.0001) and the development of laryngeal stenosis (p = 0.0450). Tracheostomy was performed in 14 (36.8%) children. Patients undergoing tracheostomy presented more extubation failures and longer intubation periods. Eight (21%) developed laryngeal stenosis, and 17 (58.6%) had complete resolution on follow-up.
CONCLUSIONS: Post-extubation laryngitis is a frequent diagnosis among patients with clinical symptoms or failed extubation. The severity of laryngeal lesions was linked to a less favorable prognosis observed at one-year follow-up. Otolaryngological evaluation, follow-up protocols, and increased access to therapeutic resources are essential to manage these children properly.
METHODS: Level 4.
METHODS: Retrospective study including children up to 13 years old at a tertiary hospital between March 2020 and March 2022 with diagnosis of post-extubation laryngitis confirmed by endoscopic examination. Exclusion criteria were prior history of intubation or anatomical airway abnormalities. Medical records were reviewed to characterize patients, underlying diagnosis, laryngeal lesions, treatment, and outcomes at 12-month follow-up.
RESULTS: The study included 38 endoscopically confirmed post-extubation laryngitis cases, corresponding to 86.4% of suspected cases. The mean age was 13.24 months, and 60.5% were male. Acute respiratory failure was the leading cause of intubation. Initial treatment was clinical, and initial diagnosis was defined by nasopharynoglaryngoscopy and/or Microlaryngoscopy and Bronchoscopy (MLB) findings. Initial diagnostic MLB was performed in 65.7% of the patients. Approximately half (53%) of the patients exhibited moderate or severe laryngeal lesions. When compared to mild cases, these patients experienced a higher rate of extubation failures (mean of 1.95 vs. 0.72, p = 0.0013), underwent more endoscopic procedures, and faced worse outcomes, such as the increased need for tracheostomy (p = 0.0001) and the development of laryngeal stenosis (p = 0.0450). Tracheostomy was performed in 14 (36.8%) children. Patients undergoing tracheostomy presented more extubation failures and longer intubation periods. Eight (21%) developed laryngeal stenosis, and 17 (58.6%) had complete resolution on follow-up.
CONCLUSIONS: Post-extubation laryngitis is a frequent diagnosis among patients with clinical symptoms or failed extubation. The severity of laryngeal lesions was linked to a less favorable prognosis observed at one-year follow-up. Otolaryngological evaluation, follow-up protocols, and increased access to therapeutic resources are essential to manage these children properly.
METHODS: Level 4.
摘要：
目的：描述拔管后喉炎的发生，分析其一年的演变，并将喉部病变与临床结果相关联。
方法：回顾性研究包括2020年3月至2022年3月在三级医院就诊的13岁以下儿童，经内镜检查确诊为拔管后喉炎。排除标准是插管或解剖气道异常的既往史。对医疗记录进行了审查，以描述患者的特征，潜在诊断，喉部病变,治疗,和12个月随访时的结果。
结果：该研究包括38例经内镜证实的拔管后喉炎病例，相当于86.4%的疑似病例。平均年龄为13.24个月，60.5%为男性。急性呼吸衰竭是插管的主要原因。最初的治疗是临床治疗，初始诊断由鼻咽喉镜和/或显微喉镜和支气管镜(MLB)检查结果确定.65.7%的患者进行了初始诊断MLB。大约一半（53％）的患者表现出中度或重度喉部病变。与轻度病例相比，这些患者的拔管失败发生率较高(平均1.95vs.0.72,p=0.0013),接受了更多的内窥镜手术，面临更糟糕的结果，例如气管造口术的需求增加（p=0.0001）和喉狭窄的发展（p=0.0450）。14例（36.8％）儿童进行了气管切开术。接受气管造口术的患者出现更多的拔管失败和更长的插管时间。8人（21%）出现喉狭窄，17人(58.6%)对后续行动有完全解决。
结论：在有临床症状或拔管失败的患者中，拔管后喉炎是常见的诊断。喉部病变的严重程度与一年随访时观察到的不良预后有关。耳鼻咽喉科评估，后续协议，增加获得治疗资源对于妥善管理这些儿童至关重要。
方法：第4级。
方法：回顾性研究包括2020年3月至2022年3月在三级医院就诊的13岁以下儿童，经内镜检查确诊为拔管后喉炎。排除标准是插管或解剖气道异常的既往史。对医疗记录进行了审查，以描述患者的特征，潜在诊断，喉部病变,治疗,和12个月随访时的结果。
结果：该研究包括38例经内镜证实的拔管后喉炎病例，相当于86.4%的疑似病例。平均年龄为13.24个月，60.5%为男性。急性呼吸衰竭是插管的主要原因。最初的治疗是临床治疗，初始诊断由鼻咽喉镜和/或显微喉镜和支气管镜(MLB)检查结果确定.65.7%的患者进行了初始诊断MLB。大约一半（53％）的患者表现出中度或重度喉部病变。与轻度病例相比，这些患者的拔管失败发生率较高(平均1.95vs.0.72,p=0.0013),接受了更多的内窥镜手术，面临更糟糕的结果，例如气管造口术的需求增加（p=0.0001）和喉狭窄的发展（p=0.0450）。14例（36.8％）儿童进行了气管切开术。接受气管造口术的患者出现更多的拔管失败和更长的插管时间。8人（21%）出现喉狭窄，17人(58.6%)对后续行动有完全解决。
结论：在有临床症状或拔管失败的患者中，拔管后喉炎是常见的诊断。喉部病变的严重程度与一年随访时观察到的不良预后有关。耳鼻咽喉科评估，后续协议，增加获得治疗资源对于妥善管理这些儿童至关重要。
方法：第4级。
