Laryngeal Trauma
Article Sidebar
Main Article Content
Abstract
Introduction
Laryngeal trauma can be an immediately life-threatening entity. Failure to recognize such injuries and delay in securing the airway may have fatal results. Early diagnosis and accurate evaluation with proper treatment is vital.
Materials and Methods
Fifteen patients with laryngotracheal injuries were analyzed prospectively. The outcome was assessed both in terms of voice and airway, on short term and long term basis.
Result
Commonest cause of injury was suicidal followed by road traffic accidents and strangulation. The main presenting symptoms and signs were stridor, hoarseness, haemoptysis and odynophagia. Five patients suffered penetrating trauma and ten patient sustained blunt trauma. Sites of laryngeal injury included; hyoid bone fracture, mixed soft tissue and cartilaginous injuries, thyrohyoid membrane and cricothyroid membrane injuries. Eleven patients presented within 24 hours of the injury. Outcome (airway and voice) was good in ten patients whereas it was poor in three patients. Poor results were seen in patients who had delayed surgical intervention.
Conclusion
Early surgical intervention is recommended for traumatic laryngeal injuries to ensure a good outcome; which further depends upon patient’s condition, injury and treatment-specific factors.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Rathlev NK, Medzon R, Bracken ME. Evaluation and management of neck trauma. Emerg Med Clin North Am. 2007; 25(3):679-94
Kohli A, Bhadoria P, Bhalotra A, Anand R, Goyal P. An unusual laryngeal injury. Indian J Anaesth. 2007; 51(1):57-9
Kandogan T, Olgun L, Gültekin G, AydarL, Mercan B, Ozuer ZM. External laryngeal trauma. Swiss Med Wkly. 2003; 133:372
Adebola SO, Ologe FE, Ogunkeyede SA, Adedayo GA, Ogundoyin OA. Penetrating anterior neck injury: a multidisciplinary approach. IOSR J Dent Med Sci. 2014; 13:20-4
Schaefer SD. The acute management of external neck trauma. A 27-year experience. Arch Otolaryngol Head Neck Surg. 1992; 118:598-604
Bent JP, Silver JR, Porubsky ES. Acute laryngeal trauma: a review of 77 patients. Otolaryngology-Head and Neck Surgery 1993;109: 441-9
Jewett BS, Shockley WW, Rutledge R. External laryngeal trauma analysis of 392 patients. Archives of Otolaryngology-Head and Neck Surgery 1999; 125:877-80
Schaefer SD, Close LC. Acute management of laryngeal trauma. Annals of Otology Rhinology and Laryngology 1989; 98:98-104
Fuhrman GM, Stieg FH, Buerk CA. Blunt trauma: classification and management protocol. Journal of Trauma 1990; 30:87-92
Maran AGD. Trauma and stenosis of the larynx. In: Scott-Browns' Otolaryngology. 6th ed. England: Butterworth Heinemann; 1997, pp 5/8/1
Chagnon FP, Mulder DS. Laryngotracheal trauma. Chest Surgery Clinics of North America 1996; 6:733-48
Henderson S et al. Aerodigestive tract injuries of the neck. American Journal of Surgery 2001; 67:75-9
Grewal H, Rao PM, Mukerji S, Ivatury RR. Management of penetrating laryngotracheal injuries. Head and Neck 1995;17 494-502
Croce MA et al. Laryngotracheal injuries. American Journal of Surgery 1992; 58:181-7
Mathisen DJ, Grillo HC. Laryngotracheal trauma. Annals of Thoracic Surgery1987; 43: 254-62
Bhojani RA et al. Contemporary assessment of laryngotracheal trauma. Journal of Thoracic and Cardiovascular Surgery 2005;130:426-32
Gussack GS, Jurkovich GJ, Luterman A. Laryngotracheal trauma: a protocol approach to a rare injury. Laryngoscope 1986; 96:660-5
Schaefer SD. The acute management of external laryngeal trauma: a 27 year experience. Archives of Otolaryngology Head and Neck Surgery 1992;118:598-604
Reece CP, Shatney CH. Blunt injuries of the cervical trachea: a review of 51 patients. Southern Medical Journal 1988; 81:1542-7
Fogelman IVlJ, Stewart RD. Penetrating wounds of the neck. American Journal of Surgery 1956; 91:391-3
Stone HH, Callahan GS. Soft tissue injuries of the neck. Surgery Gynecology and Obstetrics 963;117:745
Demetriades D, Charalambides D, Lakhoo M. Physical examination and selective conservative management in patients with penetrating injuries of the neck. British
Journal of Surgery 1993; 80:1534-6
Leopold DA. Laryngeal trauma. A historical comparison of treatment methods. Archives of Otolaryngology Head and Neck Surgery 1983;109:106-12
Downey WL, Owen RC, Ward PH. Traumatic laryngeal injury – its management and sequelae. Southern Medical Journal 1977; 60:756-60.