Pediatric Acute External Laryngeal Trauma: A Case Report (original) (raw)

External laryngeal trauma: analysis of thirty cases

The Journal of Laryngology & Otology, 1993

A retrospective analysis of thirty patients with external laryngeal trauma was performed to assess the type and extent of injuries commonly seen as well as the outcome following treatment. Outcome was assessed both in terms of voice and airway. Major laryngeal injuries (19 cases) outnumbered minor injuries (11 cases). A good correlation exists between the symptoms of haemoptysis and stridor at presentation and severity of the injury (p = 0.002). Early surgical intervention is associated with better outcome (p = 0.01). However there is no statistically significant difference in outcome between major and minor injuries (p = 0.3) indicating that other factors are operative in determining outcome. Based on our findings a management strategy for patients with external laryngeal trauma is outlined.

Case Report: Acute Management of External Laryngeal Trauma

Ear, Nose & Throat Journal, 2000

External laryngeal trauma is rare, accounting for less than 1% of all trauma cases seen at major eenters. We report the ease ofa man who experieneed multiple injuries, including an externallaryngeal trauma. The primary signs and symptoms ofhis laryngeal trauma were hoarseness, hemoptysis, the loss of his laryngeal prominenee (Adam 's apple), neek tenderness, traumatic emphysema in the neek, and a small penetrating wound to the right of the laryngeal prominenee. The patient underwent immediate tracheostomy and surgical exploration. On longterm followup, his voice quality and airway pateney improved. This ease illustrates the importance of rapid identifieation and early management of laryngotraeheal trauma in a patient with multiple injuries.

Trends in blunt laryngotracheal trauma in children

International journal of pediatric otorhinolaryngology, 2009

To examine the presentation, mechanisms, and management of blunt laryngotracheal trauma in a pediatric population, emphasizing the rise in severity. Retrospective analysis of laryngotracheal trauma evaluated from 1995 to 2008. The presentation, mechanism, management and outcomes data are detailed. Tertiary medical center. Thirty-five patients were identified with major laryngotracheal trauma. Surgical results, airway patency, voicing, swallowing and other residual disabilities are tabulated. Average age was 10.8 years, with boys outnumbering girls 22-13. In cases of major trauma, mechanisms were related to motor vehicle accidents (MVAs) in seven patients. Five of 11 major trauma victims were unconscious at presentation. Definitive airway reconstruction involved laryngotracheoplasty and tracheal resection/reanastomosis. Ten of 11 remain decannulated. In an increasingly mobile society, major laryngotracheal trauma is occurring in a younger population. Victims of major laryngotracheal ...

Laryngeal Trauma: External Approaches

Operative Techniques in Otolaryngology-Head and Neck Surgery, 2020

When endolaryngeal approaches are inadequate and when there is significant injury to the larynx, transcervical approaches are necessary. This is most often necessary for Schaefer-Fuhrman Class II-IV. Assessment and treatment always begin with evaluation and management of the airway followed by operative endoscopy to determine the extent of injury and guide surgical repair. Treatment includes open reduction and fixation of cartilaginous fractures but when there is significant endolaryngeal injury, a laryngofissure with or without stenting is often necessary. Postoperative care continues until decannulation. Secondary procedures may be required.

Acute external laryngotracheal trauma: Diagnosis and management

Ear, nose, & throat journal

Laryngotracheal trauma may result in lifelong complications or even death if diagnosis or treatment is delayed. Emergency room physicians, trauma surgeons, anesthesiologists, and especially otolaryngologists should maintain a high level of awareness of and suspicion for laryngotracheal trauma whenever a patient presents with multiple trauma in general or with cervical trauma in particular. Although there is some controversy regarding care, treatment in experienced hands will usually result in a favorable outcome. In this article, we review and update the diagnosis and management of acute external laryngotracheal trauma.

A case series of penetrating laryngeal trauma managed without tracheotomy

Charles procedure for tissue destruction after silicone injection

Background: This study is a case series that involves two patients with penetrating laryngeal trauma managed without tracheotomy. Laryngeal trauma is a rare but potentially life-threatening injury. Injuries involving Zone II of the neck are classically managed with a tracheotomy. Our aim is to illustrate that in select cases Zone II laryngeal trauma can be surgically managed conservatively without tracheotomy or stenting. Case Presentation: The two patients presented in this study both had penetrating trauma to the anterior neck in zone 2. While they were not in distress, both had subcutaneous air, loss of laryngeal prominence on exam, and fracture of the thyroid cartilage. In both cases the airway was secured via awake fiberoptic intubation, neck exploration and fracture fixation performed using sutures and microplates via a single incision through an extension of the original traumatic wound. Esophagoscopy was performed at the time of exploration and a brief period of endotracheal intubation was used to manage the airway, avoiding the use of laryngeal stenting. Conclusion: In select cases zone II/Schaefer-Fuhrman group 3 laryngeal trauma can be surgically managed without tracheotomy or stenting, without compromising the basic tenets of airway management and patient safety. The above management led to a shorter hospital stay than advocated for in the literature and improved cosmetic outcome without any adverse voice or swallowing outcomes.

External laryngotracheal trauma

European Archives of Oto-Rhino-Laryngology, 2005

Differences in acute external injuries of the larynx and cervical trachea between peacetime and war trauma were studied. Twenty-six patients with peacetime injuries and 39 patients with war injuries were retrospectively analyzed. The incidence of peacetime laryngotracheal injuries was 0.91% of the total number of patients hospitalized for head and neck injuries. In the groups of wounded in action (WIA) and killed in action (KIA) with head and neck war injuries, the incidence of laryngotracheal injuries was 4.8 and 6.2%, respectively. According to the type of the wound, blunt injuries were most common among peacetime and penetrating wounds among war injuries. There was no difference between peacetime and war injuries according to the wound localization. War wounds were more severe, caused more extensive local tissue and organ defects, were associated with a greater number of lesions to the neck and other body regions and more often required reconstructive surgical procedures than peacetime injuries. The mortality of war laryngotracheal injuries was two times greater than that of peacetime lesions (9 vs. 3.8%).

Laryngotracheal trauma: its management and sequelae

JPMA. The Journal of the Pakistan Medical Association, 2008

Laryngotracheal trauma is a rare but clinically important injury. Complications are frequent. Early recognition, accurate evaluation and proper treatment is vital. In order to learn from our past experience and refine our management, we reviewed our cases Fifteen patients with external laryngotracheal injuries were analyzed retrospectively. The outcome was assessed both in terms of voice and airway, on short term and long term basis. Commonest cause of injury was cut throat injuries followed by road traffic accidents. The main presenting symptoms and signs were hoarseness, haemoptysis, odynophagia and stridor. Major laryngeal injuries (10 cases) outnumbered minor injuries (5 cases). A good association exists between the symptoms of haemoptysis and stridor at presentation and severity of the injury. Sites of laryngeal injury included; thyroid cartilage, mixed soft tissue and cartilaginous injuries, thyrohyoid membrane, aryepiglottic fold and cricothyroid membrane. Ten patients presen...

Extensive Laryngotracheal Trauma

The Internet Journal of Otorhinolaryngology, 2009

Isolated laryngotracheal trauma is rare in modern days. Evaluation and treatment (time and mode of treatment) of these types of injury varies from patient to patient and surgeon to surgeon. Air way maintenance is the first priority irrespective of type and cause of trauma. We are reporting this case to give importance to do early tracheostomy in air way breach cases in spite of no stridor at presentation. Inexperience Surgeon should wait till the proper radiological and clinical evaluations are not done.