RESUMO
OBJECTIVE: To evaluate the incidence of subglottic stenosis in children undergoing endotracheal intubation. METHODS: Children in the paediatric intensive care unit of a tertiary care hospital were considered eligible for inclusion if they received endotracheal intubation for more than 24 hours. After extubation, children underwent flexible fibre-optic nasolaryngoscopy. Based on this first evaluation, they were divided into two groups: 'acute normal', with mild laryngeal alterations or normal findings; and 'acute alterations', with moderate to severe laryngeal alterations. Further laryngoscopic follow up (7-10 days later) was undertaken for those children in the acute normal group who developed symptoms during follow up (after discharge from the intensive care unit), and for all children in the acute alterations group. Children were then classified into two final groups: 'normal final examination', with no chronic changes; and 'subglottic stenosis'. RESULTS: We included 123 children. The incidence of subglottic stenosis was 11.38 per cent (95 per cent confidence interval, 6.63-17.94 per cent). All the children who developed subglottic stenosis had had moderate to severe alterations immediately after extubation. CONCLUSION: This incidence of subglottic stenosis is quite high and needs further investigation to identify risk factors.
Assuntos
Glote/fisiopatologia , Intubação Intratraqueal/efeitos adversos , Laringoestenose/epidemiologia , Criança , Pré-Escolar , Humanos , Incidência , Laringoscopia , Laringoestenose/diagnóstico , Laringoestenose/etiologia , Masculino , Prevalência , Estudos ProspectivosRESUMO
In this study, the authors analysed retrospectively 161 patients with acquired immunodeficiency syndrome interned at the Hospital de Clinicas de Porto Alegre. 115 (71.4%) presented with otolaryngologic lesions. 92.2% were male. The great majority were white and aged between 20 and 50 years of age (88.7%). Homosexual and bisexual males were the most frequent risk group (72.2%). Oropharyngeal candidiasis was the most prevalent head and neck manifestation (86%). Other less common lesions were sinusitis (19.1%) and Kaposi sarcoma (7.8%), mainly on the hard palate. The recognition of these manifestations by the otolaryngologist is important in order to make an early diagnosis and to treat them.