Vocal fold immobility following burn intensive care

OBJECTIVE: To evaluate factors associated with the development of vocal fold immobility in patients surviving burn intensive care. STUDY DESIGN AND SETTING: A retrospective review of patients referred to Department of Speech Pathology by the Burn Intensive Care Unit between June 2002 and November 2004. Patients underwent videostroboscopic examination, and associations of vocal fold immobility with factors related to patient management were examined by using logistic regression. RESULTS: Vocal fold immobility was diagnosed in 25 (48%) of the 52 patients evaluated. A significant association with a history of intubation during overseas aeromedical evacuation (odds ratio 4.5, P = 0.026) was observed. Multivariate modeling demonstrated an increased risk of 3% for each % total body surface area (TBSA) of burn. CONCLUSION: High-altitude transport of intubated patients was a significant risk factor in the development of laryngeal injury. SIGNIFICANCE: This study magnifies the role that endotracheal tube cuff pressure may play in recurrent laryngeal nerve injury. (C) 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.