Acute laryngeal lesions following endotracheal intubation: Risk factors, classification and treatment

Laryngeal stenosis is certainly one of the most severe complications of airway intubation in children, eventually leading to tracheostomy and sometimes to additional surgical procedures. Primary prophy-laxis through modification of its risk factors and secondary prophylaxis through the management of post-extubation laryngeal acute lesions seem to be key to avoidance of this fearful complication. The present article addresses known risk factors for the development of laryngeal acute lesions with em-phasis on sedation level and intubation time. It also discusses available classification systems proposed in medical literature, especially the Classification of Acute Laryngeal Injuries (CALI) conceived by our re-search group, and its positive predictive value for the development of chronic lesions. Finally, debate focuses on treatment of each individual lesion. Despite excellent results observed with endoscopic meth-ods for treating these lesions, there is still doubts pending over their management, and there is need for further studies to define adequate treatment for each patient and for each type of lesion. (c) 2021 Elsevier Inc. All rights reserved.