Management of Laryngotracheal Trauma: A Five-Year Single Institution Experience

Document Type : Original

Authors

1 Department of ENT and Head Neck Surgery, AIIMS Bhubaneswar, Bhubaneswar-751019, Odisha, India.

2 Department of ENT, Sri Lakshmi Narayana Institute of Medical Sciences, Pondicherry- 09, Pondicherry, India.

3 Department of ENT and Head Neck Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India.

Abstract

Introduction:
Laryngotracheal trauma is a rare life-threatening emergency that requires early identification and immediate intervention. Here, we present 26 patients with laryngotracheal trauma from a tertiary hospital in India. The aim was to describe the clinical presentation and management of laryngotracheal trauma patients.
 
Materials and Methods:
This was a retrospective study of laryngotracheal trauma patients treated between January 2011 and March 2016. Patients who presented with a breach in the laryngotracheal framework were included, while those who had penetrating neck injuries superficial to strap muscles/platysma, burn injuries, caustic ingestion, or endotracheal injuries were excluded from the study.
 
Results:
Of 253 patients with neck injury, 26 (23 adults, three children; 21 males, five females; age range, 5-60 years) presented with a breach in the laryngotracheal framework (15 blunt neck-trauma patients and 11 penetrating neck-trauma patients). The most common cause of neck injury was road traffic accidents, seen in 12 patients (46.2%). Computed tomography (CT) was performed in all blunt trauma cases and in four patients with penetrating trauma. All penetrating trauma patients underwent neck exploration. Twelve blunt trauma patients (46.1%) were managed conservatively, while three (11.5%) required surgical intervention. The most common neck exploration finding noted in patients with a penetrating injury was fracture of the thyroid cartilage, which was seen in eight patients (30.8%). Twenty patients (76.9%) had a normal voice, five patients (19.2%) had a hoarse voice, and one patient (3.8%) had a breathy voice post treatment.
 
Conclusion:
Early intervention of laryngotracheal trauma is crucial. The role of a CT scan is essential in decision making in blunt trauma cases.

Keywords

Main Subjects

References

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Iranian Journal of Otorhinolaryngology
Volume 30, Issue 5 - Serial Number 100
September and October 2018
Pages 283-290

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