PhD defence L.L. (Laura) Veder

Brief summary:

Every endotracheal intubation has the potential to cause airway injury varying from localized edema and erythema to severe laryngeal lesions with chronic consequences, such as a severe, life-threatening laryngotracheal stenosis, which may sometimes necessitate a tracheostomy. 
This dissertation investigates factors possibly involved in the development of laryngeal injury after intubation in the pediatric population. The development of post-intubation injury turned out to be a multifactorial phenomenon, and the role of certain associated factors is difficult to prove. Physicians have specialty-specific factors that they consider to be associated with the development of post-intubation injury and tailor their actions accordingly. 

This dissertation also focuses on the clinical outcomes of children with a tracheostomy. A tracheostomy negatively impacts the quality of life for patients, their families, and caregivers, making prompt decannulation desirable. To provide accurate information regarding expectations and prognosis, we evaluated the clinical outcomes of children with a tracheostomy. It is found to be strongly dependent on the indication for the tracheostomy in combination with the accompanying comorbidities. Additionally, we have shown that in children with a tracheostomy, (silent) aspiration is frequently diagnosed. These results indicate that early logopedic examination should be part of the standard care in children with a tracheostomy tube to diagnose and treat swallowing problems.
Finally, this dissertation focuses on the voice-related quality of life of the child and the optimal settings for flexible endoscopes, both essential for the follow-up of children with (previous) airway problems.