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67 long intubated, critically ill patients were examined by direct laryngoscopy between the 3rd and 14th day of intubation. It was found that even after 5 days most of the patients investigated had severe laryngeal damage. Damage occurs preferentially on the vocal cord (laryngeal granuloma), on the arytenoid vocal process and on the cricoidal plates (ulcerations). It is concluded that laryngoscopy should be performed after 5 days of intubation at the latest to determine the extent of laryngeal damage. If necessary, secondary tracheotomy should be considered.
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